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Medial gastrocnemius muscle stiffness cannot explain the increased ankle joint range of motion following passive stretching in children with cerebral palsy.

Kalkman, BM, Bar-On, L, Cenni, F, Maganaris, CN, Bass, A, Holmes, G, Desloovere, K, Barton, GJ and O'Brien, TD (2017) Medial gastrocnemius muscle stiffness cannot explain the increased ankle joint range of motion following passive stretching in children with cerebral palsy. Experimental Physiology. ISSN 1469-445X

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Abstract

Stretching is often used to increase/maintain joint range of motion (ROM) in children with cerebral palsy (CP) but the effectiveness of these interventions is limited. Therefore, this study aimed to determine the acute changes in muscle-tendon lengthening properties that contribute to increased ROM after a bout of stretching in children with CP. Eleven children with spastic CP (age:12.1(3)y, 5/6 hemiplegia/diplegia, 7/4 GMFCS level I/II) participated in this study. Each child received 3 sets of 5 × 20 s passive, manual static dorsiflexion stretches separated by 30 s rest, and 60 s rest between sets. Pre- and immediately post-stretching, ultrasound was used to measure medial gastrocnemius fascicle lengthening continuously over the full ROM and an individual common ROM pre- to post-stretching. Simultaneously, 3D motion of two marker clusters on the shank and the foot was captured to calculate ankle angle, and ankle joint torque was calculated from manually applied torques and forces on a 6DoF load cell. After stretching, ROM was increased (9.9° (12.0), P = 0.005). Over a ROM common to both pre and post measurements, there were no changes in fascicle lengthening or torque. The maximal ankle joint torque tolerated by the participants increased (2.9(2.4) Nm, P = 0.003) and at this highest passive torque maximal fascicle length was 2.8(2.4) mm greater (P = 0.009) when compared to before stretching. These results indicate that the stiffness of the muscle fascicles in children with CP remain unaltered by an acute bout of stretching. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information: This is the accepted version of the following article: Kalkman, B. M., Bar-On, L., Cenni, F., Maganaris, C. N., Bass, A., Holmes, G., Desloovere, K., Barton, G. J. and O'Brien, T. D. (), Medial gastrocnemius muscle stiffness cannot explain the increased ankle joint range of motion following passive stretching in children with cerebral palsy. Exp Physiol. Accepted Author Manuscript. doi:10.1113/EP086738, which has been published in final form at http://dx.doi.org/10.1113/EP086738
Uncontrolled Keywords: 0606 Physiology, 1116 Medical Physiology, 1106 Human Movement And Sports Science
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Sport & Exercise Sciences
Publisher: Wiley
Related URLs:
Date Deposited: 17 Jan 2018 12:36
Last Modified: 18 Sep 2018 13:29
DOI or Identification number: 10.1113/EP086738
URI: http://researchonline.ljmu.ac.uk/id/eprint/7868

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