Changes of calf muscle-tendon biomechanical properties induced by passive-stretching and active-movement training in children with cerebral palsy

Heng Zhao, Yi Ning Wu, Miriam Hwang, Yupeng Ren, Fan Gao, Deborah Gaebler-Spira, Li Qun Zhang

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Biomechanical properties of calf muscles and Achilles tendon may be altered considerably in children with cerebral palsy (CP), contributing to childhood disability. It is unclear how muscle fascicles and tendon respond to rehabilitation and contribute to improvement of ankle-joint properties. Biomechanical properties of the calf muscle fascicles of both gastrocnemius medialis (GM) and soleus (SOL), including the fascicle length and pennation angle in seven children with CP, were evaluated using ultrasonography combined with biomechanical measurements before and after a 6-wk treatment of passive-stretching and active-movement training. The passive force contributions from the GM and SOL muscles were separated using flexed and extended knee positions, and fascicular stiffness was calculated based on the fascicular force-length relation. Biomechanical properties of the Achilles tendon, including resting length, cross-sectional area, and stiffness, were also evaluated. The 6-wk training induced elongation of muscle fascicles (SOL: 8%, P = 0.018; GM: 3%, P = 0.018), reduced pennation angle (SOL: 10%, P = 0.028; GM: 5%, P = 0.028), reduced fascicular stiffness (SOL: 17%, P = 0.128; GM: 21%, P = 0.018), decreased tendon length (6%, P = 0.018), increased Achilles tendon stiffness (32%, P = 0.018), and increased Young's modulus (20%, P = 0.018). In vivo characterizations of calf muscles and Achilles tendon mechanical properties help us better understand treatment-induced changes of calf muscle-tendon and facilitate development of more effective treatments.

Original languageEnglish (US)
Pages (from-to)435-442
Number of pages8
JournalJournal of Applied Physiology
Volume111
Issue number2
DOIs
StatePublished - Aug 2011

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Muscle Stretching Exercises
Cerebral Palsy
Achilles Tendon
Tendons
Muscles
Skeletal Muscle
Ankle Joint
Elastic Modulus
Ultrasonography
Knee
Therapeutics
Rehabilitation

Keywords

  • Achilles tendon
  • Muscle fascicles
  • Pennation
  • Stiffness
  • Ultrasonography

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Changes of calf muscle-tendon biomechanical properties induced by passive-stretching and active-movement training in children with cerebral palsy. / Zhao, Heng; Wu, Yi Ning; Hwang, Miriam; Ren, Yupeng; Gao, Fan; Gaebler-Spira, Deborah; Zhang, Li Qun.

In: Journal of Applied Physiology, Vol. 111, No. 2, 08.2011, p. 435-442.

Research output: Contribution to journalArticle

Zhao, Heng ; Wu, Yi Ning ; Hwang, Miriam ; Ren, Yupeng ; Gao, Fan ; Gaebler-Spira, Deborah ; Zhang, Li Qun. / Changes of calf muscle-tendon biomechanical properties induced by passive-stretching and active-movement training in children with cerebral palsy. In: Journal of Applied Physiology. 2011 ; Vol. 111, No. 2. pp. 435-442.
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abstract = "Biomechanical properties of calf muscles and Achilles tendon may be altered considerably in children with cerebral palsy (CP), contributing to childhood disability. It is unclear how muscle fascicles and tendon respond to rehabilitation and contribute to improvement of ankle-joint properties. Biomechanical properties of the calf muscle fascicles of both gastrocnemius medialis (GM) and soleus (SOL), including the fascicle length and pennation angle in seven children with CP, were evaluated using ultrasonography combined with biomechanical measurements before and after a 6-wk treatment of passive-stretching and active-movement training. The passive force contributions from the GM and SOL muscles were separated using flexed and extended knee positions, and fascicular stiffness was calculated based on the fascicular force-length relation. Biomechanical properties of the Achilles tendon, including resting length, cross-sectional area, and stiffness, were also evaluated. The 6-wk training induced elongation of muscle fascicles (SOL: 8{\%}, P = 0.018; GM: 3{\%}, P = 0.018), reduced pennation angle (SOL: 10{\%}, P = 0.028; GM: 5{\%}, P = 0.028), reduced fascicular stiffness (SOL: 17{\%}, P = 0.128; GM: 21{\%}, P = 0.018), decreased tendon length (6{\%}, P = 0.018), increased Achilles tendon stiffness (32{\%}, P = 0.018), and increased Young's modulus (20{\%}, P = 0.018). In vivo characterizations of calf muscles and Achilles tendon mechanical properties help us better understand treatment-induced changes of calf muscle-tendon and facilitate development of more effective treatments.",
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