Exploring gastrocnemius medialis behavior during gait in children with cerebral palsy across different gait patterns

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-05-31 DOI:10.1016/j.clinbiomech.2025.106568

Babette Mooijekind , Marjolein M. van der Krogt , Eline Flux , Kaat Desloovere , Francesco Cenni , Annemieke I. Buizer , Lynn Bar-On

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引用次数: 0

Abstract

Background

Children with spastic cerebral palsy show varied gait patterns and muscle morphological alterations. We explored gastrocnemius medialis behavior during gait in typically developing children and children with cerebral palsy across different gait patterns.

Methods

Eighteen children with spasticity of the leg muscles (female: 8, age: 11.1 ± 3.3 y) with a diagnosis of cerebral palsy (n = 17) or hereditary spastic paraplegia (n = 1) and 16 typically developing children (female: 11, age: 11.2 ± 3.2 y) walked on an instrumented treadmill. Three distinct gait patterns were determined in children with cerebral palsy. Muscle-tendon unit, fascicle, belly, and tendon behavior were assessed with dynamic ultrasound imaging. Unpaired statistical non-parametric mapping (SnPM) t-tests and Mann-Whitney U tests assessed differences between children with cerebral palsy and typically developing children. One-way ANOVA SnPM tests and Kruskall-Wallis tests assessed differences across gait patterns.

Findings

Tendon lengthening in the first half of stance was higher in children with cerebral palsy compared to typically developing children (Δ6.6 mm), yet total tendon lengthening in stance (Δ5.3 mm) and fascicle shortening during push-off were decreased (Δ6.2 mm). Children with cerebral palsy displaying a mildly affected kinematic gait pattern showed pathological muscle belly lengthening in stance (Δ5.7 mm), while children with equinus (Δ6.4 mm) or crouch gait (Δ6.0 mm) showed reduced tendon lengthening.

Interpretation

Efficient gastrocnemius medialis behavior is compromised in children with spastic cerebral palsy. Children with mildly affected gait show the most deviation in muscular components involved in active force generation, while those with equinus and crouch gait also show deviations in tendinous components. Interventions aimed at improving gait should consider this aberrant behavior.

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探讨脑瘫患儿在不同步态模式下的腓肠肌内侧肌行为

背景痉挛性脑瘫患儿表现出不同的步态模式和肌肉形态改变。我们研究了典型发育儿童和脑瘫儿童在不同步态模式下的腓肠肌内侧肌行为。方法18例下肢肌肉痉挛患儿（女8例，年龄11.1±3.3岁）诊断为脑瘫（n = 17）或遗传性痉挛性截瘫（n = 1）， 16例正常发育患儿（女11例，年龄11.2±3.2岁）在带器械的跑步机上行走。在脑瘫儿童中确定了三种不同的步态模式。动态超声成像评估肌肉肌腱单元、肌束、腹部和肌腱行为。非配对统计非参数映射（SnPM） t检验和Mann-Whitney U检验评估了脑瘫儿童与正常发育儿童之间的差异。单因素方差分析SnPM检验和Kruskall-Wallis检验评估步态模式的差异。研究结果：脑瘫儿童站立前半段的肌腱延长比正常发育的儿童高（Δ6.6 mm），但站立时总肌腱延长（Δ5.3 mm）和推离时肌腱束缩短减少（Δ6.2 mm）。表现出轻度运动步态模式影响的脑瘫儿童在站立时表现出病理性肌肉腹部延长（Δ5.7 mm），而马蹄形步态（Δ6.4 mm）或蹲姿步态（Δ6.0 mm）的儿童表现出肌腱延长减少。解释：痉挛型脑瘫患儿有效的腓肠肌内侧肌行为受到损害。轻度影响步态的儿童在参与主动发力的肌肉成分上偏差最大，而马蹄形和蹲姿步态的儿童在肌腱成分上也有偏差。旨在改善步态的干预措施应考虑到这种异常行为。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.