Original articleAssessment of Muscle Endurance of the Knee Extensor Muscles in Adolescents With Spastic Cerebral Palsy Using a Submaximal Repetitions-to-Fatigue Protocol
Section snippets
Study design and setting
This cross-sectional observational study was performed in 2 rehabilitation settings (VU University Medical Center, Amsterdam; Rehabilitation Center Heliomare, Wijk aan Zee). Approval was provided by the ethical committee. All subjects signed informed consent. In addition, all parents or legal guardians of adolescents under 18 years old signed the informed consent.
Participants
Sixteen adolescents with spastic CP and 18 TD adolescents within the age range of 12 to 19 years old were recruited for the study.
Participants
Table 1 presents the participants' characteristics. Boys and girls were equally distributed over the groups (χ2=.169, P=.681). TD adolescents were significantly taller than the adolescents with CP (P<.05). The remaining characteristics did not differ between the groups. Analysis showed significantly lower knee extension torque (MVT) for adolescents with CP compared with the preferred leg of TD adolescents (t=4.313, P<.01).
RTF tests
A typical example of RTF tests of a TD adolescent is shown in figure 1.
Discussion
This study aimed to compare muscle endurance in adolescents with spastic CP and TD adolescents using a submaximal RTF protocol. An important finding from this investigation is that the relative load endurance curve of adolescents with CP at high-load conditions (>50% MVT) showed a slightly steeper slope than TD adolescents. With an increase of the RM, adolescents with CP showed a somewhat larger decrease in relative (%MVT) load than the TD adolescents. On the basis of this finding, the muscle
Conclusions
In contrast with previous studies,5, 6 our submaximal RTF protocol demonstrates that adolescents with CP show slightly lower muscle endurance in comparison with TD adolescents. Accordingly, adolescents with CP have somewhat reduced capacity to endure activities at similar relative loads compared with TD adolescents. As becomes apparent from the absolute load endurance curve, adolescents with CP have a considerably reduced ability to sustain submaximal absolute loads, similar to those challenged
Suppliers
- a.
HUMAC NORM; Lode, Zernikepark 16, 9747 AN Groningen, The Netherlands.
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Biodex Medical Systems Inc, 20 Ramsey Rd, Shirley, NY 11967.
- c.
TMSi, Zutphenstraat 57, 7575 EJ Oldenzaal, The Netherlands.
- d.
AURION, Viale Certosa 191, 20151 Milano, Italy.
- e.
Mathworks Inc, 3 Apple Hill Dr, Natick, MA 01760-2098.
- f.
IBM Corp, 1 New Orchard Rd, Armonk, NY 10504-1722.
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Cited by (16)
Energetics of walking in individuals with cerebral palsy and typical development, across severity and age: A systematic review and meta-analysis
2021, Gait and PostureCitation Excerpt :This reduced force-generating capacity of the muscle in individuals with CP might result with high relative demand of lower limb skeletal muscles during walking, making these individuals more prone to fatigue. These results are consistent with findings showing lower muscle endurance in quadriceps muscles of CP undergoing a submaximal repetition-to-fatigue protocol compared to control subjects [103]. In addition, it has been recently shown that the decrease of EMG median frequency and increase of EMG amplitude in lower leg muscles were larger in children with CP compared to typically developing peers during overground walking at self-selected speed [15].
Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients
2017, Research in Developmental DisabilitiesCitation Excerpt :Similarly, discrepant results have been found for the knee flexors (Eken et al., 2013; Moreau et al., 2016; Moreau et al., 2008). In contrast, some studies found patients with CP to be less fatigue resistant than their peers when EMG activity (Eken et al., 2014) or time-to-task failure (Eken et al., 2013; Leunkeu et al., 2010) were used, while some other studies found a similar fatigue resistance in the two populations with these same fatigue indexes (Eken et al., 2014; Leunkeu et al., 2010; Moreau et al., 2016). Overall, these results show that when force output is used to monitor fatigue development, a similar or lower fatigue level is observed in patients with CP in comparison to their peers, whereas discrepant results are observed when EMG activity is used (Table 3).
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Supported by the Revalidatiefonds (grant no. R2010142) and JohannaKinderFonds and Kinderfonds Adriaanstichting (grant no. 2011-044).
Disclosures: none.