Article

OBJECTIVE: To investigate intrinsic stiffness changes using real-time
sonoelastography (RTS) in the medial gastrocnemius muscle (GCM) after
rehabilitation therapy with botulinum toxin type A (BTA) injection in spastic
cerebral palsy (CP). DESIGN: Prospective study using ultrasonography and RTS.
SETTING: An inpatient rehabilitation clinic. PARTICIPANTS: Children (N=17) with
spastic CP (mean age, 57+/-22y, age range, 26-110mo). INTERVENTION:
Rehabilitation therapy and intramuscular injection of BTA in both medial and
lateral GCMs. MAIN OUTCOME MEASURES: RTS was obtained on the medial GCM, and the
elastic pattern of the medial GCM was graded from RTS 1 (purple to green: soft)
to RTS 4 (red: stiff) on the basis of color-scaled RTS. RTS score, color
histogram, Modified Ashworth Scale (MAS) score of the ankle plantar flexor
muscles, and Gross Motor Function Measure (GMFM) score were obtained before
intervention and 4 weeks after intervention. The correlations among RTS score,
GMFM, and MAS score were determined. Intrarater reliability was also evaluated.
RESULTS: Before and at 4 weeks after intervention, the mean RTS score decreased
from 3.4 to 1.5 (P<.05), median red pixel intensity decreased from 112.5 to 101.3
(P<.05), median blue pixel intensity increased from 82.6 to 90.4 (P<.05), mean
MAS score of the ankle decreased from 2.7 to 1.3 (P<.05), and mean GMFM score
increased from 54.55% to 62.32%. Significant correlations were observed between
the RTS score and the MAS score. Intrarater reliability was high. CONCLUSIONS:
Our results suggest that more information about the change of spastic muscle in
CP after rehabilitation treatment with BTA may be gained by estimating muscle
stiffness using RTS combined with clinical scale measurements.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS