Spastic paresis (SP) is a common motor condition in children and is often caused by cerebral palsy. Skeletal muscles develop differently in children with SP due to brain damage in early development; muscle strength and muscle length are reduced compared to typically developing (TD) children. Especially, the calf muscles are affected, which particularly affects their ability to walk and to run, hindering participation in society. There are several treatments aimed to increase the range of motion of the joint by lengthening the muscle, for example botulinum toxin injections. However, these treatments can have a weakening effect on the muscle due to deconditioning from immobilization and due to paralysis. In rehabilitation centers in the Netherlands functional power training (MegaPower) is offered to children with SP who want to walk and run better. It has been shown that this training improves calf muscle strength and performance during functional walking tests. However, the effect of MegaPower training on muscle morphology (i.a. muscle volume and length) is still unknown. Therefore, the aim of this study is to assess the effect of MegaPower training on the muscle morphology of the medial gastrocnemius in children with SP using 3D ultrasonography. It is expected that MegaPower training results in an increase of muscle volume as well as elongation of the muscle belly. Muscle volume could increase due to hypertrophy of the muscle fibers induced by the training, which could elongate the muscle belly length due to the pennate structure of the medial gastrocnemius. A double-baseline design will be applied for this study with three different measurement times (T0-T1-T2) to compare the training period (12 weeks) with a period (12 weeks) of usual care.
Study Type
OBSERVATIONAL
Enrollment
23
The training consists of weighted running and walking exercises performed at high-velocity and is given three times a week for 12 weeks.
Reade
Amsterdam, Netherlands
RECRUITINGMuscle volume in dm^3
Time frame: 12 weeks before start training (week -12)
Muscle volume in dm^3
Time frame: At the start of training (week 0)
Muscle volume in dm^3
Time frame: At the end of the training (week 12)
Muscle belly length in mm
Time frame: 12 weeks before start training (week -12)
Muscle belly length in mm
Time frame: At the start of training (week 0)
Muscle belly length in mm
Time frame: At the end of the training (week 12)
Tendon length in mm
Time frame: 12 weeks before start training (week -12)
Tendon length in mm
Time frame: At the start of training (week 0)
Tendon length in mm
Time frame: At the end of the training (week 12)
Fascicle length in mm
Time frame: 12 weeks before start training (week -12)
Fascicle length in mm
Time frame: At the start of training (week 0)
Fascicle length in mm
Time frame: At the end of the training (week 12)
Isometric muscle strength of the medial gastrocnemius
Measured with a hand-held dynamometer in Nm.
Time frame: At the start of training (week 0)
Isometric muscle strength of the medial gastrocnemius
Measured with a hand-held dynamometer in Nm.
Time frame: At the end of the training (week 12)
Dynamic muscle strength
Standing heel-rise test on one leg. Measured in amount of repetitions.
Time frame: At the start of training (week 0)
Dynamic muscle strength
Standing heel-rise test on one leg. Measured in amount of repetitions.
Time frame: At the end of the training (week 12)
Functional Strength Measure (FSM)
Measurement for lower and upper limb functionality.
Time frame: At the start of training (week 0)
Functional Strength Measure (FSM)
Measurement for lower and upper limb functionality.
Time frame: At the end of the training (week 12)
1-minute-walk-test
Distance (m) covered in 1 min walking.
Time frame: At the start of training (week 0)
1-minute-walk-test
Distance (m) covered in 1 min walking.
Time frame: At the end of the training (week 12)
10m Shuttle run test
Measured in amount of steps reached.
Time frame: At the start of training (week 0)
10m Shuttle run test
Measured in amount of steps reached.
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Time frame: At the end of the training (week 12)
6x15m sprint
Measured as average time (s) over 6x15 m sprint.
Time frame: At the start of training (week 0)
6x15m sprint
Measured as average time (s) over 6x15 m sprint.
Time frame: At the end of the training (week 12)
Ankle range of motion
Maximal dorsiflexion in degrees manually measured with a goniometer.
Time frame: At the start of training (week 0)
Ankle range of motion
Maximal dorsiflexion in degrees manually measured with a goniometer.
Time frame: At the end of the training (week 12)
Body weight in kg
Time frame: 12 weeks before start training (week -12)
Body weight in kg
Time frame: At the start of training (week 0)
Body weight in kg
Time frame: At the end of the training (week 12)
Body length in m
Time frame: 12 weeks before start training (week -12)
Body length in m
Time frame: At the start of training (week 0)
Body length in m
Time frame: At the end of the training (week 12)
Lower leg length in mm
Measured from the lateral malleolus and tibial plateau.
Time frame: 12 weeks before start training (week -12)
Lower leg length in mm
Measured from the lateral malleolus and tibial plateau.
Time frame: At the start of training (week 0)
Lower leg length in mm
Measured from the lateral malleolus and tibial plateau.
Time frame: At the end of the training (week 12)