title: Gastrocnemius muscle-tendon interaction during walking in typically-developing adults and children, and in children with spastic cerebral palsy.
abstract: Our understanding of the interaction of muscle bellies and their tendons in individuals with muscle pathology is limited. Knowledge of these interactions may inform us of the effects of musculoskeletal pathologies on muscle-tendon dynamics and the subsequent neurological control strategies used in gait. Here, we investigate gastrocnemius muscle-tendon interaction in typically-developing (TD) adults and children, and in children with spastic cerebral palsy (SCP).
  
  
  
  We recruited six TD adults (4 female; mean age: 34 yrs. (24-54)), eight TD children (5 female; mean age: 10 yrs. (6-12)) and eight independently ambulant children with SCP (5 female; mean age 9 yrs. (6-12); 3 unilaterally-affected). A combination of 3D motion capture and 2D real-time ultrasound imaging were used to compute the gastrocnemius musculo-tendinous unit (MTU) length and estimate muscle belly and tendon lengths during walking. For the TD subjects, the measurements were made for heel-toe walking and voluntary toe-walking.
  
  
  
  The gastrocnemius muscle bellies of children with SCP lengthened during single support (p = 0.003). In contrast, the muscle bellies of TD subjects did not demonstrate an increase in length over the period of single support under heel-toe or toe-walking conditions.
  
  
  
  We observed lengthening of the gastrocnemius muscle bellies in children with SCP during single support, a phase of the gait cycle in which the muscle is reported consistently to be active. Repeated lengthening of muscle bellies while they are active may lead to muscle damage and have implications for the natural history of gait in this group.
authors.affiliation: Clinical Physics, Barts Health NHS Trust, The Royal London Hospital, 56-76 Ashfield Street, Whitechapel, London E1 1BB, UK; One Small Step Gait Laboratory, Guy׳s and St. Thomas' NHS Foundation Trust, Guy׳s Hospital, London SE1 9RT, UK. Electronic address: Gursharan.Kalsi@nhs.net.
authors.forename: Gursharan
authors.initials: G
authors.lastname: Kalsi
authors.affiliation: One Small Step Gait Laboratory, Guy׳s and St. Thomas' NHS Foundation Trust, Guy׳s Hospital, London SE1 9RT, UK.
authors.forename: Nicola R
authors.initials: NR
authors.lastname: Fry
authors.affiliation: One Small Step Gait Laboratory, Guy׳s and St. Thomas' NHS Foundation Trust, Guy׳s Hospital, London SE1 9RT, UK; Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King׳s College London, King׳s Health Partners,St. Thomas' Hospital, London SE1 7EH, UK.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Shortland
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D002657:Child Development / Q000502:physiology*; D005260:Female; D005684:Gait / Q000502:physiology; D006365:Heel / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology*; D013710:Tendons / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology*; D014463:Ultrasonography; D016138:Walking / Q000502:physiology*
keywords: Cerebral palsy; Muscle-tendon interaction; Ultrasound