Association of activities of daily living and cognitive function with thickness of the upper extremity muscles in children and adults with cerebral palsy.

PURPOSE: We examined the association of activities of daily living (ADL) and cognitive function with the upper extremity muscle thickness and upper extremity range of motion (ROM) and spasticity in children and adults with cerebral palsy (CP). METHODS: The subjects were 20 children and adults with CP. The ADL performed using the upper extremities and cognitive function were assessed using the self-care domain of the Pediatric Evaluation of Disability Inventory (PEDI) and the full-scale intelligence quotient (FSIQ) of the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV), respectively. The WISC-IV was assessed in only seven of 20 subjects able to undergo evaluation. The thickness of the upper extremity muscles was measured using an ultrasound imaging device. Moreover, ROM and spasticity of the upper extremities were assessed using the Modified Ashworth Scale (MAS). Manual manipulation ability was also assessed using the Manual Ability Classification System (MACS). RESULTS: Stepwise regression analysis revealed that the extensor digitorum muscle thickness and MACS level were significant and independent factors of self-care in the PEDI. Partial correlation analysis with MACS level and age as control variables showed that the FSIQ of the WISC-IV was significantly associated with the thickness of the anterior fibers of the deltoid and flexor digitorum superficialis muscles. CONCLUSION: Reduced ADL performed using the upper extremities is associated with decreased extensor digitorum muscle thickness rather than ROM and spasticity of the upper extremities in children and adults with CP.

Association of gross motor function and activities of daily living with muscle mass of the trunk and lower extremity muscles, range of motion, and spasticity in children and adults with cerebral palsy.

PURPOSE: We examined the association of gross motor function and activities of daily living (ADL) with muscle mass of the trunk and lower extremity muscles in children and adults with cerebral palsy (CP). METHODS: The subjects were 32 children and adults with CP. Muscle thickness of the trunk and lower extremity muscles was measured using an ultrasound imaging device. RESULTS: Stepwise regression analysis revealed that the thoracic erector spinae muscle thickness was a significant and independent factor of gross motor function. Stepwise regression analysis also showed that the thickness of the rectus abdominis and vastus lateralis muscles were significant and independent factors of ADL. CONCLUSIONS: Our findings suggest that declined gross motor function is associated with decreased thoracic erector spinae muscle mass in children and adults with CP. The results also indicate that declined ADL is associated with decreased muscle mass of the rectus abdominis and vastus lateralis muscles.

Comparison of the degree of pes planovalgus and muscle mass of the ankle joint and foot muscles between children with Down syndrome and children with typical development.

We aimed to compare the degree of pes planovalgus and muscle mass of the ankle joint and foot muscles between children with Down syndrome (DS) and children with typical development (TD). We also examined the association of the degree of pes planovalgus with muscle mass of the ankle joint and foot muscles in children with DS and children with TD. The subjects were 24 children with TD (control [CTR] group) and 23 children with DS (DS group). To assess pes planovalgus, the Arch Height Index (AHI) in the standing position was measured. Muscle thickness of the ankle joint and foot muscles was measured using an ultrasound imaging device. The AHI and thickness of the soleus and tibialis posterior muscles were significantly lower in the DS group than those in the CTR group. The thickness of the flexor digitorum longus muscle was significantly greater in the DS group than that in the CTR group. Stepwise regression analysis revealed that the thickness of the flexor digitorum longus muscle was a significant and independent factor of the AHI in children comprising the CTR and DS groups. The thickness of the flexor digitorum longus muscle increased with decreasing AHI. The results of this study suggest that the AHI and muscle mass of the soleus and tibialis posterior muscles decrease, while muscle mass of the flexor digitorum longus muscle increases in children with DS. The results also indicate that decreased AHI is associated with increased muscle mass of the flexor digitorum longus muscle in children.