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Jean-michel Gracies - One of the best experts on this subject based on the ideXlab platform.

  • duration of symptom relief between injections for abobotulinumtoxina dysport in Spastic Paresis and cervical dystonia comparison of evidence from clinical studies
    Frontiers in Neurology, 2020
    Co-Authors: Alberto Esquenazi, Mauricio R Delgado, Robert A Hauser, Philippe Picaut, Keith Foster, Andreas Lysandropoulos, Jean-michel Gracies
    Abstract:

    Background: Botulinum toxin-A is a well-established treatment for adult and pediatric Spastic Paresis and cervical dystonia. While guidelines and approved labels indicate that treatment should not occur more frequently than every 12 weeks, studies and real-world evidence show that the timing of symptom recurrence between treatments may vary. Methods: We report retreatment criteria and response duration (retreatment intervals) from four pivotal, double-blind, placebo-controlled studies with open-label extensions involving patients treated with abobotulinumtoxinA (aboBoNTA) for upper limb (NCT01313299) or lower limb (NCT01249404) Spastic Paresis in adults, lower limb Spastic Paresis in children (NCT01249417), and cervical dystonia in adults (NCT00257660). We review results in light of recently available preclinical data. Results: In Spastic Paresis, 24.0-36.9% of upper limb patients treated with aboBoNTA and 20.1-32.0% of lower limb patients did not require retreatment before 16 weeks. Moreover, 72.8-93.8% of aboBoNTA-treated pediatric patients with lower limb Spastic Paresis did not require retreatment before 16 weeks (17.7-54.0% did not require retreatment before 28 weeks). In aboBoNTA-treated patients with cervical dystonia, 72.6-81.5% did not require retreatment before 16 weeks. Conclusion: AboBoNTA, when dosed as recommended, offers symptom relief beyond 12 weeks to many patients with Spastic Paresis and cervical dystonia. From recently available preclinical research, the amount of active neurotoxin administered with aboBoNTA might be a factor in explaining this long duration of response.

  • the neurophysiology of deforming Spastic Paresis a revised taxonomy
    Annals of Physical and Rehabilitation Medicine, 2019
    Co-Authors: Marjolaine Baude, Jens Nielsen, Jean-michel Gracies
    Abstract:

    Abstract This paper revisits the taxonomy of the neurophysiological consequences of a persistent impairment of motor command execution in the classic environment of sensorimotor restriction and muscle hypo-mobilization in short position. Around each joint, the syndrome involves 2 disorders, muscular and neurologic. The muscular disorder is promoted by muscle hypo-mobilization in short position in the context of Paresis, in the hours and days after Paresis onset: this genetically mediated, evolving myopathy, is called Spastic myopathy. The clinician may suspect it by feeling extensibility loss in a resting muscle, although long after the actual onset of the disease. The neurologic disorder, promoted by sensorimotor restriction in the context of Paresis and by the muscle disorder itself, comprises 4 main components, mostly affecting antagonists to desired movements: the first is Spastic dystonia, an unwanted, involuntary muscle activation at rest, in the absence of stretch or voluntary effort; Spastic dystonia superimposes on Spastic myopathy to cause visible, gradually increasing body deformities; the second is Spastic cocontraction, an unwanted, involuntary antagonist muscle activation during voluntary effort directed to the agonist, aggravated by antagonist stretch; it is primarily due to misdirection of the supraspinal descending drive and contributes to reducing movement amplitude; and the third is Spasticity, one form of hyperreflexia, defined by an enhancement of the velocity-dependent responses to phasic stretch, detected and measured at rest (another form of hyperreflexia is “nociceptive spasms”, following flexor reflex afferent stimulation, particularly after spinal cord lesions). The 3 main forms of overactivity, Spastic dystonia, Spastic cocontraction and Spasticity, share the same motor neuron hyperexcitability as a contributing factor, all being predominant in the muscles that are more affected by Spastic myopathy. The fourth component of the neurologic disorder affects the agonist: it is stretch-sensitive Paresis, which is a decreased access of the central command to the agonist, aggravated by antagonist stretch. Improved understanding of the pathophysiology of deforming Spastic Paresis should help clinicians select meaningful assessments and refined treatments, including the utmost need to preserve muscle tissue integrity as soon as Paresis sets in.

  • impact of stretched position of a shortened muscle on active command in Spastic Paresis
    Annals of Physical and Rehabilitation Medicine, 2015
    Co-Authors: M Balugani, A Alrahoomi, Cosimo Costantino, Emilie Hutin, Jean-michel Gracies
    Abstract:

    Background In Spastic Paresis, factors limiting active movement include antagonist contracture, agonist Paresis, and Spastic cocontraction. We studied agonist and antagonist muscle activation around the elbow to determine the role of the degree of muscle stretch in modifying Paresis and cocontraction. Methods Eighteen healthy (age 47 ± 10) and 15 hemiparetic (age 42 ± 16) subjects performed maximal isometric elbow flexion and extension 5-second efforts, with elbow flexed and extended. Using biceps and triceps brachii surface electromyography, we determined for each muscle: (i) the Mean Rectified Voltage (MRV) during the 500 ms peak voluntary agonist recruitment elbow flexed (MRVago500F) and elbow extended (MRVago500E); (ii) the coefficient of stretch-sensitivity (CSS) of agonist recruitment, calculated as (MRVago500F-MRVago500E)/MRVago500F; (iii) the cocontraction index (CCI) in each elbow position, ratio of the MRV from each muscle during an opposite movement, MRVantago5 to MRVago500. We compared the dominant arm in healthy subjects with the non-paretic and paretic arms in hemiparetic subjects. Results XV1 was 175 ± 11° in the elbow flexors (maximal passive elbow extension; coefficient of shortening, 2.7%) and 163 ± 7° in the elbow extensors (no shortening). CSS was not significantly different from 0 in the healthy and non-paretic arm; however, CSS in the paretic arm was −21 ± 10% in the paretic elbow extensors vs −4 ± 7% in the non-paretic arm (P vs extended, P = 0.013). Triceps brachii CCI with the elbow flexed was 0.10 ± 0.05 [95%CI, 0.03–0.17], 0.15 ± 0.10 [0.07–0.23] and 0.26 ± 0.24 [0.18–0.34], in the healthy, non-paretic and paretic arm respectively (between-group difference P = 0.011), and 0.12 ± 0.06 [95%CI, 0.03–0.21], 0.15 ± 0.08 [0.06–0.25], and 0.38 ± 0.32 [0.28–0.48] with the elbow extended (between-group difference P vs extended, NS). Conclusions In hemiParesis, elbow extended position deteriorates active command at both agonist and antagonist levels: decreasing voluntary recruitment of agonist MNs–a phenomenon defined as stretch-sensitive Paresis–and increasing antagonist co-contraction. This may occur through physiological effects of high-threshold afferent fiber recruitment in contractured elbow flexors.

  • daily static and eccentric self stretching program and changes in muscle functional length in chronic Spastic Paresis after one year of guided self rehabilitation contract s practice
    Annals of Physical and Rehabilitation Medicine, 2015
    Co-Authors: Maud Pradines, Marjolaine Baude, Emilie Hutin, V Mardale, Jean-michel Gracies
    Abstract:

    Objective To evaluate the impact of a daily self-stretching program within a Guided Self-rehabilitation Contract (GSC), on functional muscle length in patients with chronic Spastic Paresis. Methods Retrospective chart review of 16 chronic paretic patients (7 W, age 40 ± 8 years, time since lesion 57 ± 35 months) who consecutively participated to a Guided Self-rehabilitation Contract for at least one year (2 years follow-up for 10 of them). By this contract, patients were committed to clinicians to achieve every day a self-stretching program based on self-stretching postures (> 10 mn/muscle/day) and excentric stretching exercises on some selected muscles (“self-stretched” muscles). Each program was specific for each patient. Functional muscle length XV1 (angle of arrest after slow and strong stretch) measured by the clinician at every visit on 5 key muscles of the lower limb (soleus, gastrocnemius, hamstrings, vastus, rectus femoris), they have been selected or not for the self-stretching program, was the main outcome measure. Coefficient of shortening (CS) was calculated CR = (XN–XV1)/XN (XN, normal passive amplitude). After one and two years, muscles has been considered as responders if, from baseline, ΔXV1 > 10° for hamstrings, vastus and rectus femoris, and > 5° for soleus and gastrocnemius. Results In retrospect, at baseline, CS for the non-stretched muscles group was 0.12 ± 0.03 (mean ± SD) vs 0.20 ± 0.02 in the self-stretched muscles group (P = 0,028, t test). The percent of responders in the self-stretched muscles group was significantly higher than in the non-stretched muscles group after one and two years of GSC (42% vs 20%, P = 0.025; 50% vs 20%, P = 0.035 respectively, Chi2). After one year, the CS of the self-stretched muscles group decreased about 18%, vs 5% for the non-stretched muscles group (P = 0.028, Mann-Whitney). Regarding individual muscles data, raw functional lengthening after two years of daily self-stretched (n = 10) were: hamstrings, +9 ± 6; vastus, +6 ± 2; rectus femoris, +13 ± 7; soleus, +2 ± 2; gastrocnemius, +3 ± 1. Conclusion A customized program of self-stretching daily practiced by chronic paretic patients for at least one year within a Guided Self-rehabilitation Contract might allow a significant functional muscle lengthening. These results need to be confirmed by a prospective controlled study.

  • coefficients of impairment in deforming Spastic Paresis
    Annals of Physical and Rehabilitation Medicine, 2015
    Co-Authors: Jean-michel Gracies
    Abstract:

    Abstract This position paper introduces an assessment method using staged calculation of coefficients of impairment in Spastic Paresis, with its rationale and proposed use. The syndrome of deforming Spastic Paresis superimposes two disorders around each joint: a neural disorder comprising stretch-sensitive Paresis in agonists and antagonist muscle overactivity, and a muscle disorder (“Spastic myopathy”) combining shortening and loss of extensibility in antagonists. Antagonist muscle overactivity includes Spastic cocontraction (misdirected descending command), Spastic dystonia (tonic involuntary muscle activation, at rest) and Spasticity (increased velocity-dependent reflexes to phasic stretch, at rest). This understanding of various types of antagonist resistance as the key limiting factors in paretic movements prompts a stepwise, quantified, clinical assessment of antagonist resistances, elaborating on the previously developed Tardieu Scale. Step 1 quantifies limb function (e.g. ambulation speed in lower limb, Modified Frenchay Scale in upper limb). The following four steps evaluate various angles X of antagonist resistance, in degrees all measured from 0°, position of minimal stretch of the tested antagonist. Step 2 rates the functional muscle length, termed X V1 (V1, slowest stretch velocity possible), evaluated as the angle of arrest upon slow and strong passive muscle stretch. X V1 is appreciated with respect to the expected normal passive amplitude, X N , and reflects combined muscle contracture and residual Spastic dystonia. Step 3 determines the angle of catch upon fast stretch, termed X V3 (V3, fastest stretch velocity possible), reflecting Spasticity. Step 4 measures the maximal active range of motion against the antagonist, termed X A , reflecting agonist capacity to overcome passive (stiffness) and active (Spastic cocontraction) antagonist resistances over a single movement. Finally, Step 5 rates the residual active amplitude after 15 seconds of maximal amplitude rapid alternating movements, X A15 . Amplitude decrement from X A to X A15 reflects fatigability. Coefficients of shortening (X N  – X V1 )/X N , Spasticity (X V1  – X V3 )/X V1 , weakness (X V1  – X A )/X V1 and fatigability (X A  – X A15 )/X A are derived. A high (e.g., >10%) coefficient of shortening prompts aggressive treatment of the muscle disorder – e.g. by stretch programs, such as prolonged stretch postures –, while high coefficients of weakness or fatigability prompt addressing the neural motor command disorder, e.g. using training programs such as repeated alternating movements of maximal amplitude.

Reinald Brunner - One of the best experts on this subject based on the ideXlab platform.

  • Outcome of medial hamstring lengthening in children with Spastic Paresis: A biomechanical and morphological observational study
    2018
    Co-Authors: Helga Haberfehlner, K. Van Hutten, Richard T. Jaspers, Erich Rutz, M.m.e.h. Witbreuk, Jacqueline Romkes, Jaap Harlaar, Johannes A. Van Der Sluijs, Marie Freslier, Reinald Brunner
    Abstract:

    To improve gait in children with Spastic Paresis due to cerebral palsy or hereditary Spastic Paresis, the semitendinosus muscle is frequently lengthened amongst other medial hamstring muscles by orthopaedic surgery. Side effects on gait due to weakening of the hamstring muscles and overcorrections have been reported. How these side effects relate to semitendinosus morphology is unknown. This study assessed the effects of bilateral medial hamstring lengthening as part of single-event multilevel surgery (SEMLS) on (1) knee joint mechanics (2) semitendinosus muscle morphology and (3) gait kinematics. All variables were assessed for the right side only. Six children with Spastic Paresis selected for surgery to counteract limited knee range of motion were measured before and about a year after surgery. After surgery, in most subjects popliteal angle decreased and knee moment-angle curves were shifted towards a more extended knee joint, semitendinosus muscle belly length was approximately 30% decreased, while at all assessed knee angles tendon length was increased by about 80%. In the majority of children muscle volume of the semitendinosus muscle decreased substantially suggesting a reduction of physiological cross-sectional area. Gait kinematics showed more knee extension during stance (mean change ± standard deviation: 34±13°), but also increased pelvic anterior tilt (mean change ± standard deviation: 23±5°). In most subjects, surgical lengthening of semitendinosus tendon contributed to more extended knee joint angle during static measurements as well as during gait, whereas extensibility of semitendinosus muscle belly was decreased. Post-surgical treatment to maintain muscle belly length and physiological cross-sectional area may improve treatment outcome of medial hamstring lengthening.

  • Knee Moment-Angle Characteristics and Semitendinosus Muscle Morphology in Children with Spastic Paresis Selected for Medial Hamstring Lengthening.
    PloS one, 2016
    Co-Authors: Helga Haberfehlner, Richard T. Jaspers, Erich Rutz, M.m.e.h. Witbreuk, Jacqueline Romkes, Jaap Harlaar, Jules G. Becher, Johannes A. Van Der Sluijs, Marie Freslier, Reinald Brunner
    Abstract:

    To increase knee range of motion and improve gait in children with Spastic Paresis (SP), the semitendinosus muscle (ST) amongst other hamstring muscles is frequently lengthened by surgery, but with variable success. Little is known about how the pre-surgical mechanical and morphological characteristics of ST muscle differ between children with SP and typically developing children (TD). The aims of this study were to assess (1) how knee moment-angle characteristics and ST morphology in children with SP selected for medial hamstring lengthening differ from TD children, as well as (2) how knee moment-angle characteristics and ST morphology are related. In nine SP and nine TD children, passive knee moment-angle characteristics and morphology of ST (i.e. fascicle length, muscle belly length, tendon length, physiological cross-sectional area, and volume) were assessed by hand-held dynamometry and freehand 3D ultrasound, respectively. At net knee flexion moments above 0.5 Nm, more flexed knee angles were found for SP compared to TD children. The measured knee angle range between 0 and 4 Nm was 30% smaller in children with SP. Muscle volume, physiological cross-sectional area, and fascicle length normalized to femur length were smaller in SP compared to TD children (62%, 48%, and 18%, respectively). Sixty percent of the variation in knee angles at 4 Nm net knee moment was explained by ST fascicle length. Altered knee moment-angle characteristics indicate an increased ST stiffness in SP children. Morphological observations indicate that in SP children planned for medial hamstring lengthening, the longitudinal and cross-sectional growth of ST muscle fibers is reduced. The reduced fascicle length can partly explain the increased ST stiffness and, hence, a more flexed knee joint in these SP children.

  • Knee angle at 4 Nm (θ4Nm) plotted as a function of normalized fascicle length at 0 Nm (ℓfasc0Nm) (A) and at 4 Nm (ℓfasc4Nm) (B).
    2016
    Co-Authors: Helga Haberfehlner, Richard T. Jaspers, Erich Rutz, M.m.e.h. Witbreuk, Jacqueline Romkes, Jaap Harlaar, Jules G. Becher, Johannes A. Van Der Sluijs, Marie Freslier, Reinald Brunner
    Abstract:

    Variation in ℓfasc0Nm and ℓfasc4Nm explained a substantial part of variation in θ4Nm (49% and 60%, respectively). Lines indicate the regression lines for the combined group. Separate symbols are used to indicate data points for SP (Spastic Paresis) and TD (typically developing).

  • A: Absolute and relative (rel) length changes (Δ) of the fascicles between knee angles corresponding to 0 Nm and 4 Nm net knee moment. B: Absolute and relative length changes of the distal tendon between these two knee angles.
    2016
    Co-Authors: Helga Haberfehlner, Richard T. Jaspers, Erich Rutz, M.m.e.h. Witbreuk, Jacqueline Romkes, Jaap Harlaar, Jules G. Becher, Johannes A. Van Der Sluijs, Marie Freslier, Reinald Brunner
    Abstract:

    Fascicle length and tendon length are normalized to femur length (ℓfasc_norm, ℓtdist_norm). Absolute as well as relative length changes of fascicles and tendons did not differ significantly between children with a Spastic Paresis (SP) and typically developing (TD) children. Data are presented as means ± SD.

Weide Guido - One of the best experts on this subject based on the ideXlab platform.

  • Foot flexibility confounds the assessment of triceps surae extensibility in children with Spastic Paresis during typical physical examinations
    'Elsevier BV', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Jaspers, Richard T., Harlaar J.
    Abstract:

    Accurate assessment of the talo-crural (ankle) joint angle at physical examination is important for assessing extensibility of m. triceps surae (TS) in children with Spastic cerebral Paresis (SCP). The main aim of this study was to quantify foot flexibility during standardized measurements of TS muscle-tendon complex extensibility (i.e. based on foot-sole rotation) in SCP children, and typical developed (TD) ones. Additionally, we aim to define a method that minimizes the confounding effects of foot flexibility on estimates of talo-crural joint angles and TS extensibility. Children, aged 6–13 years, with SCP (GMFCS I-III, n = 13) and TD children (n = 14) participated in this study. Externally applied −1 Nm, 0 Nm, 1 Nm and 4 Nm dorsal flexion foot plate moments were imposed. Resulting TS origin-insertion lengths, foot sole (φFoSo) rotations, and changes in talo-crural joint angle (φTaCr) were measured. Foot flexibility was quantified as Δ(φTaCr -φFoSo) between the 0 Nm and 4 Nm dorsal flexion conditions. In both groups, φFoSo rotations of approximately 20° were observed between 0 Nm and 4 Nm dorsal flexion, of which about 6° (≈30%) was related to foot flexibility. Foot flexibility correlated to φFoSo (r = 0.69) but not to φTaCr (r = 0.11). For φFoSo no significant differences were found between groups at 4 Nm. However, for SCP children the mean estimate of φTaCr was 4.3° more towards plantar flexion compared to the TD group (p < 0.05). Normalized TS lengths show a higher coefficient of correlation with φTaCr (r2 = 0.82) than with φFoSo (r2 = 0.60), indicating that TS lengths are better estimated by talo-cural joint angles. In both SCP and TD children aged 6–13 year, estimates of TS length and extensibility based on foot sole assessments are confounded by foot flexibility. Assessments of TS extensibility at physical examination will be more accurate when based on measurements of talo-crural joint angles.Accepted Author ManuscriptBiomechatronics & Human-Machine Contro

  • Foot flexibility confounds the assessment of triceps surae extensibility in children with Spastic Paresis during typical physical examinations
    'Elsevier BV', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Jaspers, Richard T., Harlaar Jaap
    Abstract:

    Accurate assessment of the talo-crural (ankle) joint angle at physical examination is important for assessing extensibility of m. triceps surae (TS) in children with Spastic cerebral Paresis (SCP). The main aim of this study was to quantify foot flexibility during standardized measurements of TS muscle-tendon complex extensibility (i.e. based on foot-sole rotation) in SCP children, and typical developed (TD) ones. Additionally, we aim to define a method that minimizes the confounding effects of foot flexibility on estimates of talo-crural joint angles and TS extensibility. Children, aged 6-13 years, with SCP (GMFCS I-III, n = 13) and TD children (n = 14) participated in this study. Externally applied -1 Nm, 0 Nm, 1 Nm and 4 Nm dorsal flexion foot plate moments were imposed. Resulting TS origin-insertion lengths, foot sole (φFoSo) rotations, and changes in talo-crural joint angle (φTaCr) were measured. Foot flexibility was quantified as Δ(φTaCr -φFoSo) between the 0 Nm and 4 Nm dorsal flexion conditions. In both groups, φFoSo rotations of approximately 20° were observed between 0 Nm and 4 Nm dorsal flexion, of which about 6° (≈30%) was related to foot flexibility. Foot flexibility correlated to φFoSo (r = 0.69) but not to φTaCr (r = 0.11). For φFoSo no significant differences were found between groups at 4 Nm. However, for SCP children the mean estimate of φTaCr was 4.3° more towards plantar flexion compared to the TD group (p 

  • Gastrocnemius Medialis Muscle Geometry and Extensibility in Typically Developing Children and Children With Spastic Paresis Aged 6–13 Years
    'Frontiers Media SA', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Harlaar Jaap, Bar-on Lynn, Buizer Annemieke, Sloot Lizeth, Jaspers, Richard T.
    Abstract:

    Gait of children with Spastic Paresis (SP) is frequently characterized by a reduced ankle range of motion, presumably due to reduced extensibility of the triceps surae (TS) muscle. Little is known about how morphological muscle characteristics in SP children are affected. The aim of this study was to compare gastrocnemius medialis (GM) muscle geometry and extensibility in children with SP with those of typically developing (TD) children and assess how GM morphology is related to its extensibility. Thirteen children with SP, of which 10 with a diagnosis of Spastic cerebral palsy and three with SP of unknown etiology (mean age 9.7 ± 2.1 years; GMFCS: I–III), and 14 TD children (mean age 9.3 ± 1.7 years) took part in this study. GM geometry was assessed using 3D ultrasound imaging at 0 and 4 Nm externally imposed dorsal flexion ankle moments. GM extensibility was defined as its absolute length change between the externally applied 0 and 4 Nm moments. Anthropometric variables and GM extensibility did not differ between the SP and TD groups. While in both groups, GM muscle volume correlated with body mass, the slope of the regression line in TD was substantially higher than that in SP (TD = 3.3 ml/kg; SP = 1.3 ml/kg, p < 0.01). In TD, GM fascicle length increased with age, lower leg length and body mass, whereas in SP children, fascicle length did not correlate with any of these variables. However, the increase in GM physiological cross-sectional area as a function of body mass did not differ between SP and TD children. Increases in lengths of tendinous structures in children with SP exceeded those observed in TD children (TD = 0.85 cm/cm; SP = 1.16 cm/cm, p < 0.01) and even exceeded lower-leg length increases. In addition, only for children with SP, body mass (r = −0.61), height (r = −0.66), muscle volume (r = − 0.66), physiological cross-sectional area (r = − 0.59), and tendon length (r = −0.68) showed a negative association with GM extensibility. Such negative associations were not found for TD children. In conclusion, physiological cross-sectional area and length of the tendinous structures are positively associated with age and negatively associated with extensibility in children with SP

  • Gastrocnemius Medialis Muscle Geometry and Extensibility in Typically Developing Children and Children With Spastic Paresis Aged 6–13 Years
    'Frontiers Media SA', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Harlaar J., Bar-on Lynn, Buizer Annemieke, Sloot Lizeth, Jaspers, Richard T.
    Abstract:

    Gait of children with Spastic Paresis (SP) is frequently characterized by a reduced ankle range of motion, presumably due to reduced extensibility of the triceps surae (TS) muscle. Little is known about how morphological muscle characteristics in SP children are affected. The aim of this study was to compare gastrocnemius medialis (GM) muscle geometry and extensibility in children with SP with those of typically developing (TD) children and assess how GM morphology is related to its extensibility. Thirteen children with SP, of which 10 with a diagnosis of Spastic cerebral palsy and three with SP of unknown etiology (mean age 9.7 ± 2.1 years; GMFCS: I–III), and 14 TD children (mean age 9.3 ± 1.7 years) took part in this study. GM geometry was assessed using 3D ultrasound imaging at 0 and 4 Nm externally imposed dorsal flexion ankle moments. GM extensibility was defined as its absolute length change between the externally applied 0 and 4 Nm moments. Anthropometric variables and GM extensibility did not differ between the SP and TD groups. While in both groups, GM muscle volume correlated with body mass, the slope of the regression line in TD was substantially higher than that in SP (TD = 3.3 ml/kg; SP = 1.3 ml/kg, p < 0.01). In TD, GM fascicle length increased with age, lower leg length and body mass, whereas in SP children, fascicle length did not correlate with any of these variables. However, the increase in GM physiological cross-sectional area as a function of body mass did not differ between SP and TD children. Increases in lengths of tendinous structures in children with SP exceeded those observed in TD children (TD = 0.85 cm/cm; SP = 1.16 cm/cm, p < 0.01) and even exceeded lower-leg length increases. In addition, only for children with SP, body mass (r = −0.61), height (r = −0.66), muscle volume (r = − 0.66), physiological cross-sectional area (r = − 0.59), and tendon length (r = −0.68) showed a negative association with GM extensibility. Such negative associations were not found for TD children. In conclusion, physiological cross-sectional area and length of the tendinous structures are positively associated with age and negatively associated with extensibility in children with SP.Biomechatronics & Human-Machine Contro

  • Foot flexibility confounds the assessment of triceps surae extensibility in children with Spastic Paresis during typical physical examinations
    'Elsevier BV', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Jaspers, Richard T., Harlaar J.
    Abstract:

    Accurate assessment of the talo-crural (ankle) joint angle at physical examination is important for assessing extensibility of m. triceps surae (TS) in children with Spastic cerebral Paresis (SCP). The main aim of this study was to quantify foot flexibility during standardized measurements of TS muscle-tendon complex extensibility (i.e. based on foot-sole rotation) in SCP children, and typical developed (TD) ones. Additionally, we aim to define a method that minimizes the confounding effects of foot flexibility on estimates of talo-crural joint angles and TS extensibility. Children, aged 6–13 years, with SCP (GMFCS I-III, n = 13) and TD children (n = 14) participated in this study. Externally applied −1 Nm, 0 Nm, 1 Nm and 4 Nm dorsal flexion foot plate moments were imposed. Resulting TS origin-insertion lengths, foot sole (φFoSo) rotations, and changes in talo-crural joint angle (φTaCr) were measured. Foot flexibility was quantified as Δ(φTaCr -φFoSo) between the 0 Nm and 4 Nm dorsal flexion conditions. In both groups, φFoSo rotations of approximately 20° were observed between 0 Nm and 4 Nm dorsal flexion, of which about 6° (≈30%) was related to foot flexibility. Foot flexibility correlated to φFoSo (r = 0.69) but not to φTaCr (r = 0.11). For φFoSo no significant differences were found between groups at 4 Nm. However, for SCP children the mean estimate of φTaCr was 4.3° more towards plantar flexion compared to the TD group (p < 0.05). Normalized TS lengths show a higher coefficient of correlation with φTaCr (r2 = 0.82) than with φFoSo (r2 = 0.60), indicating that TS lengths are better estimated by talo-cural joint angles. In both SCP and TD children aged 6–13 year, estimates of TS length and extensibility based on foot sole assessments are confounded by foot flexibility. Assessments of TS extensibility at physical examination will be more accurate when based on measurements of talo-crural joint angles.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Biomechatronics & Human-Machine Contro

Arne Jensen - One of the best experts on this subject based on the ideXlab platform.

  • Spastic Paresis after perinatal brain damage in rats is reduced by human cord blood mononuclear cells
    2015
    Co-Authors: Carola Meier, Johannes Middelanis, B Wasielewski, Sandra Neuhoff, Markus Gantert, Hubert R Dinse, Rolf Dermietzel, Astrid Roth-haerer, Arne Jensen
    Abstract:

    ABSTRACT: Brain damage around birth may cause lifelong neu-rodevelopmental deficits. We examined the therapeutic potential of human umbilical cord blood–derived mononuclear cells containing multipotent stem cells to facilitate motor recovery after cerebral hypoxic-ischemic damage in neonatal rats. Left carotid artery ligation followed by 8 % O2 inhalation for 80 min was performed on postnatal d 7, succeeded by intraperitoneal transplantation of human umbilical cord blood–derived mononuclear cells on postnatal d 8 in a sham-controlled design. Histologic and immunohistochemical analysis on postnatal d 21 revealed that neonates developed severe cerebral damage after the hypoxic-ischemic insult. These animals also suf-fered from contralateral Spastic Paresis, as evidenced by their loco-motor behavior. After transplantation of human umbilical cord blood–derived mononuclear cells, Spastic Paresis was largely allevi-ated, resulting in a normal walking behavior. This “therapeutic

  • Spastic Paresis after perinatal brain damage in rats is reduced by human cord blood mononuclear cells
    Pediatric Research, 2006
    Co-Authors: Carola Meier, Johannes Middelanis, B Wasielewski, Sandra Neuhoff, Astrid Rothhaerer, Markus Gantert, Hubert R Dinse, Rolf Dermietzel, Arne Jensen
    Abstract:

    Brain damage around birth may cause lifelong neu- rodevelopmental deficits. We examined the therapeutic potential of human umbilical cord blood-derived mononuclear cells containing multipotent stem cells to facilitate motor recovery after cerebral hypoxic-ischemicdamageinneonatalrats.Leftcarotidarteryligation

Jaspers, Richard T. - One of the best experts on this subject based on the ideXlab platform.

  • Foot flexibility confounds the assessment of triceps surae extensibility in children with Spastic Paresis during typical physical examinations
    'Elsevier BV', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Jaspers, Richard T., Harlaar J.
    Abstract:

    Accurate assessment of the talo-crural (ankle) joint angle at physical examination is important for assessing extensibility of m. triceps surae (TS) in children with Spastic cerebral Paresis (SCP). The main aim of this study was to quantify foot flexibility during standardized measurements of TS muscle-tendon complex extensibility (i.e. based on foot-sole rotation) in SCP children, and typical developed (TD) ones. Additionally, we aim to define a method that minimizes the confounding effects of foot flexibility on estimates of talo-crural joint angles and TS extensibility. Children, aged 6–13 years, with SCP (GMFCS I-III, n = 13) and TD children (n = 14) participated in this study. Externally applied −1 Nm, 0 Nm, 1 Nm and 4 Nm dorsal flexion foot plate moments were imposed. Resulting TS origin-insertion lengths, foot sole (φFoSo) rotations, and changes in talo-crural joint angle (φTaCr) were measured. Foot flexibility was quantified as Δ(φTaCr -φFoSo) between the 0 Nm and 4 Nm dorsal flexion conditions. In both groups, φFoSo rotations of approximately 20° were observed between 0 Nm and 4 Nm dorsal flexion, of which about 6° (≈30%) was related to foot flexibility. Foot flexibility correlated to φFoSo (r = 0.69) but not to φTaCr (r = 0.11). For φFoSo no significant differences were found between groups at 4 Nm. However, for SCP children the mean estimate of φTaCr was 4.3° more towards plantar flexion compared to the TD group (p < 0.05). Normalized TS lengths show a higher coefficient of correlation with φTaCr (r2 = 0.82) than with φFoSo (r2 = 0.60), indicating that TS lengths are better estimated by talo-cural joint angles. In both SCP and TD children aged 6–13 year, estimates of TS length and extensibility based on foot sole assessments are confounded by foot flexibility. Assessments of TS extensibility at physical examination will be more accurate when based on measurements of talo-crural joint angles.Accepted Author ManuscriptBiomechatronics & Human-Machine Contro

  • Foot flexibility confounds the assessment of triceps surae extensibility in children with Spastic Paresis during typical physical examinations
    'Elsevier BV', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Jaspers, Richard T., Harlaar Jaap
    Abstract:

    Accurate assessment of the talo-crural (ankle) joint angle at physical examination is important for assessing extensibility of m. triceps surae (TS) in children with Spastic cerebral Paresis (SCP). The main aim of this study was to quantify foot flexibility during standardized measurements of TS muscle-tendon complex extensibility (i.e. based on foot-sole rotation) in SCP children, and typical developed (TD) ones. Additionally, we aim to define a method that minimizes the confounding effects of foot flexibility on estimates of talo-crural joint angles and TS extensibility. Children, aged 6-13 years, with SCP (GMFCS I-III, n = 13) and TD children (n = 14) participated in this study. Externally applied -1 Nm, 0 Nm, 1 Nm and 4 Nm dorsal flexion foot plate moments were imposed. Resulting TS origin-insertion lengths, foot sole (φFoSo) rotations, and changes in talo-crural joint angle (φTaCr) were measured. Foot flexibility was quantified as Δ(φTaCr -φFoSo) between the 0 Nm and 4 Nm dorsal flexion conditions. In both groups, φFoSo rotations of approximately 20° were observed between 0 Nm and 4 Nm dorsal flexion, of which about 6° (≈30%) was related to foot flexibility. Foot flexibility correlated to φFoSo (r = 0.69) but not to φTaCr (r = 0.11). For φFoSo no significant differences were found between groups at 4 Nm. However, for SCP children the mean estimate of φTaCr was 4.3° more towards plantar flexion compared to the TD group (p 

  • Gastrocnemius Medialis Muscle Geometry and Extensibility in Typically Developing Children and Children With Spastic Paresis Aged 6–13 Years
    'Frontiers Media SA', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Harlaar Jaap, Bar-on Lynn, Buizer Annemieke, Sloot Lizeth, Jaspers, Richard T.
    Abstract:

    Gait of children with Spastic Paresis (SP) is frequently characterized by a reduced ankle range of motion, presumably due to reduced extensibility of the triceps surae (TS) muscle. Little is known about how morphological muscle characteristics in SP children are affected. The aim of this study was to compare gastrocnemius medialis (GM) muscle geometry and extensibility in children with SP with those of typically developing (TD) children and assess how GM morphology is related to its extensibility. Thirteen children with SP, of which 10 with a diagnosis of Spastic cerebral palsy and three with SP of unknown etiology (mean age 9.7 ± 2.1 years; GMFCS: I–III), and 14 TD children (mean age 9.3 ± 1.7 years) took part in this study. GM geometry was assessed using 3D ultrasound imaging at 0 and 4 Nm externally imposed dorsal flexion ankle moments. GM extensibility was defined as its absolute length change between the externally applied 0 and 4 Nm moments. Anthropometric variables and GM extensibility did not differ between the SP and TD groups. While in both groups, GM muscle volume correlated with body mass, the slope of the regression line in TD was substantially higher than that in SP (TD = 3.3 ml/kg; SP = 1.3 ml/kg, p < 0.01). In TD, GM fascicle length increased with age, lower leg length and body mass, whereas in SP children, fascicle length did not correlate with any of these variables. However, the increase in GM physiological cross-sectional area as a function of body mass did not differ between SP and TD children. Increases in lengths of tendinous structures in children with SP exceeded those observed in TD children (TD = 0.85 cm/cm; SP = 1.16 cm/cm, p < 0.01) and even exceeded lower-leg length increases. In addition, only for children with SP, body mass (r = −0.61), height (r = −0.66), muscle volume (r = − 0.66), physiological cross-sectional area (r = − 0.59), and tendon length (r = −0.68) showed a negative association with GM extensibility. Such negative associations were not found for TD children. In conclusion, physiological cross-sectional area and length of the tendinous structures are positively associated with age and negatively associated with extensibility in children with SP

  • Gastrocnemius Medialis Muscle Geometry and Extensibility in Typically Developing Children and Children With Spastic Paresis Aged 6–13 Years
    'Frontiers Media SA', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Harlaar J., Bar-on Lynn, Buizer Annemieke, Sloot Lizeth, Jaspers, Richard T.
    Abstract:

    Gait of children with Spastic Paresis (SP) is frequently characterized by a reduced ankle range of motion, presumably due to reduced extensibility of the triceps surae (TS) muscle. Little is known about how morphological muscle characteristics in SP children are affected. The aim of this study was to compare gastrocnemius medialis (GM) muscle geometry and extensibility in children with SP with those of typically developing (TD) children and assess how GM morphology is related to its extensibility. Thirteen children with SP, of which 10 with a diagnosis of Spastic cerebral palsy and three with SP of unknown etiology (mean age 9.7 ± 2.1 years; GMFCS: I–III), and 14 TD children (mean age 9.3 ± 1.7 years) took part in this study. GM geometry was assessed using 3D ultrasound imaging at 0 and 4 Nm externally imposed dorsal flexion ankle moments. GM extensibility was defined as its absolute length change between the externally applied 0 and 4 Nm moments. Anthropometric variables and GM extensibility did not differ between the SP and TD groups. While in both groups, GM muscle volume correlated with body mass, the slope of the regression line in TD was substantially higher than that in SP (TD = 3.3 ml/kg; SP = 1.3 ml/kg, p < 0.01). In TD, GM fascicle length increased with age, lower leg length and body mass, whereas in SP children, fascicle length did not correlate with any of these variables. However, the increase in GM physiological cross-sectional area as a function of body mass did not differ between SP and TD children. Increases in lengths of tendinous structures in children with SP exceeded those observed in TD children (TD = 0.85 cm/cm; SP = 1.16 cm/cm, p < 0.01) and even exceeded lower-leg length increases. In addition, only for children with SP, body mass (r = −0.61), height (r = −0.66), muscle volume (r = − 0.66), physiological cross-sectional area (r = − 0.59), and tendon length (r = −0.68) showed a negative association with GM extensibility. Such negative associations were not found for TD children. In conclusion, physiological cross-sectional area and length of the tendinous structures are positively associated with age and negatively associated with extensibility in children with SP.Biomechatronics & Human-Machine Contro

  • Foot flexibility confounds the assessment of triceps surae extensibility in children with Spastic Paresis during typical physical examinations
    'Elsevier BV', 2020
    Co-Authors: Weide Guido, Huijing, Peter A., Becher, Jules G., Jaspers, Richard T., Harlaar J.
    Abstract:

    Accurate assessment of the talo-crural (ankle) joint angle at physical examination is important for assessing extensibility of m. triceps surae (TS) in children with Spastic cerebral Paresis (SCP). The main aim of this study was to quantify foot flexibility during standardized measurements of TS muscle-tendon complex extensibility (i.e. based on foot-sole rotation) in SCP children, and typical developed (TD) ones. Additionally, we aim to define a method that minimizes the confounding effects of foot flexibility on estimates of talo-crural joint angles and TS extensibility. Children, aged 6–13 years, with SCP (GMFCS I-III, n = 13) and TD children (n = 14) participated in this study. Externally applied −1 Nm, 0 Nm, 1 Nm and 4 Nm dorsal flexion foot plate moments were imposed. Resulting TS origin-insertion lengths, foot sole (φFoSo) rotations, and changes in talo-crural joint angle (φTaCr) were measured. Foot flexibility was quantified as Δ(φTaCr -φFoSo) between the 0 Nm and 4 Nm dorsal flexion conditions. In both groups, φFoSo rotations of approximately 20° were observed between 0 Nm and 4 Nm dorsal flexion, of which about 6° (≈30%) was related to foot flexibility. Foot flexibility correlated to φFoSo (r = 0.69) but not to φTaCr (r = 0.11). For φFoSo no significant differences were found between groups at 4 Nm. However, for SCP children the mean estimate of φTaCr was 4.3° more towards plantar flexion compared to the TD group (p < 0.05). Normalized TS lengths show a higher coefficient of correlation with φTaCr (r2 = 0.82) than with φFoSo (r2 = 0.60), indicating that TS lengths are better estimated by talo-cural joint angles. In both SCP and TD children aged 6–13 year, estimates of TS length and extensibility based on foot sole assessments are confounded by foot flexibility. Assessments of TS extensibility at physical examination will be more accurate when based on measurements of talo-crural joint angles.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Biomechatronics & Human-Machine Contro