Spasticity and Its Contribution to Hypertonia in Cerebral Palsy

被引:93
作者
Bar-On, Lynn [1 ,2 ]
Molenaers, Guy [2 ,3 ,4 ]
Aertbelien, Erwin [5 ]
Van Campenhout, Anja [3 ,4 ]
Feys, Hilde [1 ]
Nuttin, Bart [6 ,7 ]
Desloovere, Kaat [1 ,2 ]
机构
[1] KU Leuven Dept Rehabil Sci, B-3000 Louvain, Belgium
[2] Univ Hosp Leuven, Clin Mot Anal Lab, B-3212 Pellenberg, Belgium
[3] KU Leuven Dept Dev & Regenerat, B-3000 Louvain, Belgium
[4] Univ Hosp Leuven, Dept Orthoped, B-3212 Pellenberg, Belgium
[5] KU Leuven Dept Mech Engn, B-3000 Louvain, Belgium
[6] KU Leuven Dept Neurosci, B-3000 Louvain, Belgium
[7] Univ Hosp Leuven, Dept Neurosurg, B-3000 Louvain, Belgium
关键词
ANKLE PLANTAR FLEXORS; BOTULINUM-TOXIN-A; MEDIAL GASTROCNEMIUS; RECIPROCAL INHIBITION; MUSCLE MORPHOLOGY; MOVEMENT-DISORDER; TENDON LENGTH; REFLEX GAIN; UPPER-LIMB; CHILDREN;
D O I
10.1155/2015/317047
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Spasticity is considered an important neural contributor to muscle hypertonia in children with cerebral palsy (CP). It is most often treated with antispasticity medication, such as Botulinum Toxin-A. However, treatment response is highly variable. Part of this variability may be due to the inability of clinical tests to differentiate between the neural (e.g., spasticity) and nonneural (e.g., soft tissue properties) contributions to hypertonia, leading to the terms "spasticity" and "hypertonia" often being used interchangeably. Recent advancements in instrumented spasticity assessments offer objective measurement methods for distinction and quantification of hypertonia components. These methods can be applied in clinical settings and their results used to fine-tune and improve treatment. We reviewed current advancements and new insights with respect to quantifying spasticity and its contribution to muscle hypertonia in children with CP. First, we revisit what is known about spasticity in children with CP, including the various definitions and its pathophysiology. Second, we summarize the state of the art on instrumented spasticity assessment in CP and review the parameters developed to quantify the neural and nonneural components of hypertonia. Lastly, the impact these quantitative parameters have on clinical decision-making is considered and recommendations for future clinical and research investigations are discussed.
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页数:10
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