Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study

Introduction: Spasticity and altered muscle tone are key features in children withneurodevelopmentaldisorders,particularlycerebralpalsy(CP).Theyimpact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle differ...

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Detalles Bibliográficos
Autores: González-Matilla, Ramón, Abuín-Porras, Vanesa, Mínguez-Esteban, Isabel, Heredia Rizo, Alberto Marcos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/177083
Acceso en línea:https://hdl.handle.net/11441/177083
https//doi.org/10.3389/fphys.2025.1588084
Access Level:acceso abierto
Palabra clave:Cerebral palsy
Muscle stiffness
Spasticity
Pain perception
Myotonometry
Descripción
Sumario:Introduction: Spasticity and altered muscle tone are key features in children withneurodevelopmentaldisorders,particularlycerebralpalsy(CP).Theyimpact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle differences in children with CP can help improve clinical assessment and therapeutic interventions. This study aims to evaluate differences in muscle tone, stiffness, ROM, and pain perception between children with CP and typically developing peers using objective biomechanical measures. Methods: An observational, cross-sectional study was conducted with 40 participants of both sexes (20 children with CP, 20 typically developing peers). Muscle tone and stiffness of the lower limb muscles were measured using the Myoton PRO device. ROM was assessed by goniometry, and pain perception was evaluated using the Visual Analog Scale during a Straight Leg Raise (SLR) test. A generalized linear mixed model was used to detect differences in myotonometry, ROM, and pain perception measurements. In participants with CP, the Pearson product-moment correlation coefficient analysis was used to explore possible associations between clinical features and muscle tone and stiffness. Results: Children with CP exhibited reduced ROM, with a significant group effect for hip flexion (P < 0.001; η2 = 0.843), knee extension (P < 0.001; η2 = 0.355), and ankle flexion (P < 0.001; η2 = 0.959) and higher pain perception during the SLR test (P < 0.001; η2 = 0.831), compared to controls. Myotonometry revealed significantly increased muscle stiffness of the rectus femoris (P = 0.004; η2 = 0.112) and adductor muscles (P = 0.019; η2 = 0.074) in the CP group, with no differences in muscle tone between the groups. Sex-related differences were found for muscle tone and stiffness, with males showing higher values. Correlation analyses indicated that adductor muscles stiffness was associated with CP severity. Conclusion: Children with CP demonstrate significant changes in ROM, pain perception, and muscle stiffness, emphasizing the need for targeted therapeutic interventions. These findings support the use of objective biomechanical tools for assessing muscle properties in clinical settings, contributing to better management strategies for spasticity-related impairments.