Abstract
Objective
To investigate the relation between lower limb muscle strength, passive muscle properties,
and functional capacity outcomes in adults with cerebral palsy (CP).
Design
Cross-sectional study.
Setting
Tertiary institution biomechanics laboratory.
Participants
Adults with spastic-type CP (N=33; mean age, 25y; range, 15–51y; mean body mass, 70.15±21.35kg)
who were either Gross Motor Function Classification System (GMFCS) level I (n=20)
or level II (n=13).
Interventions
Not applicable.
Main Outcome Measures
Six-minute walk test (6MWT) distance (m), lateral step-up (LSU) test performance (total
repetitions), timed up-stairs (TUS) performance (s), maximum voluntary isometric strength
of plantar flexors (PF) and dorsiflexors (DF) (Nm.kg−1), and passive ankle joint and muscle stiffness.
Results
Maximum isometric PF strength independently explained 61% of variance in 6MWT performance,
57% of variance in LSU test performance, and 50% of variance in TUS test performance.
GMFCS level was significantly and independently related to all 3 functional capacity
outcomes, and age was retained as a significant independent predictor of LSU and TUS
test performance. Passive medial gastrocnemius muscle fascicle stiffness and ankle
joint stiffness were not significantly related to functional capacity measures in
any of the multiple regression models.
Conclusions
Low isometric PF strength was the most important independent variable related to distance
walked on the 6MWT, fewer repetitions on the LSU test, and slower TUS test performance.
These findings suggest lower isometric muscle strength contributes to the decline
in functional capacity in adults with CP.
Keywords
List of abbreviations:
6MWT (6-minute walk test), CP (cerebral palsy), DF (dorsiflexor), GMFCS (Gross Motor Function Classification System), GMFM-66 (Gross Motor Function Measure-66), LSU (lateral step-up), MG (medial gastrocnemius), PF (plantar flexor), TD (typically developed), TUS (timed up-stairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 10, 2018
Footnotes
Supported by Cerebral Palsy International (grant no. R-810-13); the National Health and Medical Research Council of Australia (grant nos. 1075642, 1070623, and 1105038); the Cerebral Palsy Alliance (grant no. CDG213); and the Australian Rotary Health and Rotary Club of St Ives.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
