Muscle growth is reduced in 15-month-old children with cerebral palsy

AimLack of muscle growth relative to bone growth may be responsible for development of contractures in children with cerebral palsy (CP). Here, we used ultrasonography to compare growth of the medial gastrocnemius muscle in children with and without CP. MethodTwenty-six children with spastic CP (15 males, 11 females; mean age 35mo, range 8-65mo) and 101 typically developing children (47 males, 54 females; mean age 29mo, range 1-69mo) were included. Functional abilities of children with CP equalled levels I to III in the Gross Motor Function Classification System. Medial gastrocnemius muscle volume was constructed from serial, transverse, two-dimensional ultrasonography images. ResultsIn typically developing children, medial gastrocnemius volume increased linearly with age. Among children with CP, medial gastrocnemius volume increased less with age and deviated significantly from typically developing children at 15 months of age (p<0.05). Bone length increased with age without significant difference (p=0.49). InterpretationMuscle growth in children with CP initially follows that of typically developing children, but decreases at 15 months of age. This may be related to reduced physical activity and neural activation of the muscle. Interventions stimulating muscle growth in young children with CP may be important to prevent contractures. What this paper adds Medial gastrocnemius muscle volume is significantly reduced in young children with cerebral palsy (CP). The reduced muscle volume is unrelated to overall growth. Physical activity may be important to prevent muscle atrophy and contractures in young children with CP. Interventions which increase muscle volume may benefit young children with CP. This article is commented on by Barber and Boyd on pages 431-432 of this issue.