Selective dorsal rhizotomy improves muscle forces during walking in children with spastic cerebral palsy. 2019

Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
Department of Kinesiology, KU Leuven, Leuven, Belgium. Electronic address: hans.kainz@kuleuven.be.

Selective dorsal rhizotomy aims to reduce spasticity in children with cerebral palsy. Early investigations indicated postoperative weakness, whereas more recent studies showed that selective dorsal rhizotomy either does not change or improves muscle strength. All previous studies assessed muscle strength in a static position, which did not represent the walking situation. The aim of this study was to analyze the influence of selective dorsal rhizotomy on muscle forces during gait. Motion capture data of 25 children with spastic cerebral palsy and 10 typically developing participants were collected. A musculoskeletal OpenSim model was used to calculate joint kinematics, joint kinetics and muscle forces during gait. Static optimization and an electromyography-informed approach to calculate muscle forces were compared. A Muscle-Force-Profile was introduced and used to compare the muscle forces during walking before and after a selective dorsal rhizotomy. Independent of the approach used (electromyography-informed versus static optimization), selective dorsal rhizotomy significantly normalized forces in spastic muscles during walking and did not reduce the contribution of non-spastic muscles. This study showed that selective dorsal rhizotomy improves dynamic muscle forces in children with cerebral palsy and leads to less gait pathology, as shown in the improvement in joint kinematics and joint kinetics. Individual muscle force analyses using the Muscle-Force-Profile extend standard joint kinematics and joint moment analyses, which might improve clinical-decision making in children with cerebral palsy in the future. The reference data of our participants and MATLAB code for the Muscle-Force-Profile are publicly available on simtk.org/projects/muscleprofile.

UI MeSH Term Description Entries
D008297 Male Males
D009128 Muscle Spasticity A form of muscle hypertonia associated with upper MOTOR NEURON DISEASE. Resistance to passive stretch of a spastic muscle results in minimal initial resistance (a "free interval") followed by an incremental increase in muscle tone. Tone increases in proportion to the velocity of stretch. Spasticity is usually accompanied by HYPERREFLEXIA and variable degrees of MUSCLE WEAKNESS. (From Adams et al., Principles of Neurology, 6th ed, p54) Clasp-Knife Spasticity,Spastic,Clasp Knife Spasticity,Spasticity, Clasp-Knife,Spasticity, Muscle
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005260 Female Females
D005684 Gait Manner or style of walking. Gaits
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
June 1988, Developmental medicine and child neurology,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
March 2015, Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
July 2019, The Lancet. Child & adolescent health,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
September 2016, Journal of spine surgery (Hong Kong),
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
January 2001, Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
September 2007, Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
August 1998, Gait & posture,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
February 2001, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
January 1997, Journal of neurosurgery,
Hans Kainz, and Hoa Hoang, and Lorenzo Pitto, and Mariska Wesseling, and Sam Van Rossom, and Anja Van Campenhout, and Guy Molenaers, and Friedl De Groote, and Kaat Desloovere, and Ilse Jonkers
October 2018, Journal of children's orthopaedics,
Copied contents to your clipboard!