본문 바로가기
KERD
논문KCI 등재

Architectural Changes of the Gastrocnemius Muscle after Botulinum Toxin Type A Injection in Children with Cerebral Palsy

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose: This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP). Materials and Methods: Thirteen childrenwith CP who received a BoNT-A injection into their GCM to treat equinus were recruited (9 males and 4 females). Architectural changes in both the medial and lateral heads of the GCM from a total of 20 legs were assessed using B-mode, real-time US. Muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured over the middle of the muscle belly in both a resting and neutral ankle position. Measures at 1 and 3 months after the injection were compared with baseline data taken before the injection. Results: The mean age of the subjects was 5.8 (±1.6) years. Spasticity was significantly reduced when measured by both the modified Tardieu scale and the modified Ashworth scale at 1 and 3 months after injection (p<0.05). The MT and FA of both the medial and lateral heads of the GCM were significantly reduced for both neutral and resting ankle positions at 1 and 3 months after the injection. The FL of both the medial and lateral heads of the GCM were significantly increased in a resting position (p<0.05), but not in a neutralposition. Conclusion: Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.

Abstract

Purpose: This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP). Materials and Methods: Thirteen childrenwith CP who received a BoNT-A injection into their GCM to treat equinus were recruited (9 males and 4 females). Architectural changes in both the medial and lateral heads of the GCM from a total of 20 legs were assessed using B-mode, real-time US. Muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured over the middle of the muscle belly in both a resting and neutral ankle position. Measures at 1 and 3 months after the injection were compared with baseline data taken before the injection. Results: The mean age of the subjects was 5.8 (±1.6) years. Spasticity was significantly reduced when measured by both the modified Tardieu scale and the modified Ashworth scale at 1 and 3 months after injection (p<0.05). The MT and FA of both the medial and lateral heads of the GCM were significantly reduced for both neutral and resting ankle positions at 1 and 3 months after the injection. The FL of both the medial and lateral heads of the GCM were significantly increased in a resting position (p<0.05), but not in a neutralposition. Conclusion: Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.

참고문헌 (33)

  1. Lieber RL, "Structural and functional changes in spastic skeletal muscle", Muscle Nerve, 29, pp.615~627 (2004)
  2. Park GY, "Sonoelastographic Evaluation of Medial Gastrocnemius Muscles Intrinsic Stiffness After Rehabilitation Therapy With Botulinum Toxin A Injection in Spastic Cerebral Palsy", ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 93(11), pp.2085~2089 (2012), W B SAUNDERS CO-ELSEVIER INC
  3. Manske SL, "Muscle and bone follow similar temporal patterns of recovery from muscle-induced disuse due to botulinum toxin injection", Bone, 46, pp.24~31 (2010)
  4. Shen J, "How muscles recover from paresis and atrophy after intramuscular injection of botulinum toxin A: study in juvenile rats", J Orthop Res, 24, pp.1128~1135 (2006)
  5. Glass GE, "Atrophy of the intrinsic musculature of the hands associated with the use of botulinum toxin-A injections for hyperhidrosis: a case report and review of the literature", J Plast Reconstr Aesthet Surg, 62, pp.e274~e276 (2009)
  6. Choi WH, "Skeletal muscle atrophy induced by intramuscular repeated dose of botulinum toxin type A in rats", Drug Chem Toxicol, 30, pp.217~227 (2007)
  7. Schroeder AS, "Muscle biopsy substantiates long-term MRI alterations one year after a single dose of botulinum toxin injected into the lateral gastrocnemius muscle of healthy volunteers", Mov Disord, 24, pp.1494~1503 (2009)
  8. Fortuna R, "Changes in contractile properties of muscles receiving repeat injections of botulinum toxin (Botox)", J Biomech, 44, pp.39~44 (2011)
  9. Moreau NG, "In vivo muscle architecture and size of the rectus femoris and vastus lateralis in children and adolescents with cerebral palsy", Dev Med Child Neurol, 51, pp.800~806 (2009)
  10. Mohagheghi AA, "In vivo gastrocnemius muscle fascicle length in children with and without diplegic cerebral palsy", Dev Med Child Neurol, 50, pp.44~50 (2008)
  11. Tok F, "Effects of botulinum toxin-A on the muscle architecture of stroke patients: the first ultrasonographic study", J Rehabil Med, 43, pp.1016~1019 (2011)
  12. Barber L, "Medial gastrocnemius muscle volume and fascicle length in children aged 2 to 5 years with cerebral palsy", Dev Med Child Neurol, 53, pp.543~548 (2011)
  13. 나동욱, "Effect of Hinged Ankle-Foot Orthoses on Standing Balance Control in Children with Bilateral Spastic Cerebral Palsy", Yonsei Medical Journal, 51(5), pp.746~752 (2010), 연세대학교의과대학
  14. Bénard MR, "Anatomical information is needed in ultrasound imaging of muscle to avoid potentially substantial errors in measurement of muscle geometry", Muscle Nerve, 39, pp.652~665 (2009)
  15. Lichtwark GA, "Muscle fascicle and series elastic element length changes along the length of the human gastrocnemius during walking and running", J Biomech, 40, pp.157~164 (2007)
  16. Riad J, "Are muscle volume differences related to concentric muscle work during walking in spastic hemiplegic cerebral palsy?", Clin Orthop Relat Res, 470, pp.1278~1285 (2012)
  17. Bandholm T, "Dorsiflexor muscle-group thickness in children with cerebral palsy: relation to cross-sectional area", NeuroRehabilitation, 24, pp.299~306 (2009)
  18. Moreau NG, "Muscle architecture predicts maximum strength and is related to activity levels in cerebral palsy", Phys Ther, 90, pp.1619~1630 (2010)
  19. Ohata K, "Measurement of muscle thickness as quantitative muscle evaluation for adults with severe cerebral palsy", Phys Ther, 86, pp.1231~1239 (2006)
  20. Malaiya R, "The morphology of the medial gastrocnemius in typically developing children and children with spastic hemiplegic cerebral palsy", J Electromyogr Kinesiol, 17, pp.657~663 (2007)
  21. Muramatsu T, "In vivo determination of fascicle curvature in contracting human skeletal muscles", J Appl Physiol (1985), 92, pp.129~134 (2002)
  22. Williams SA, "Combining strength training and botulinum neurotoxin intervention in children with cerebral palsy: the impact on muscle morphology and strength", Disabil Rehabil, 35, pp.596~605 (2013)
  23. McNee AE, "Increases in muscle volume after plantarflexor strength training in children with spastic cerebral palsy", Dev Med Child Neurol, 51, pp.429~435 (2009)
  24. Elder GC, "Contributing factors to muscle weakness in children with cerebral palsy", Dev Med Child Neurol, 45, pp.542~550 (2003)
  25. Shortland AP, "Changes to medial gastrocnemius architecture after surgical intervention in spastic diplegia", Dev Med Child Neurol, 46, pp.667~673 (2004)
  26. Gao F, "In vivo evaluations of morphologic changes of gastrocnemius muscle fascicles and achilles tendon in children with cerebral palsy", Am J Phys Med Rehabil, 90, pp.364~371 (2011)
  27. Shortland AP, "Architecture of the medial gastrocnemius in children with spastic diplegia", Dev Med Child Neurol, 44, pp.158~163 (2002)
  28. Fehlings D, "The use of botulinum toxin in paediatric hypertonia", Paediatr Child Health, 10, pp.379~381 (2005)
  29. Kawakami Y, "Muscle-fiber pennation angles are greater in hypertrophied than in normal muscles", J Appl Physiol (1985), 74, pp.2740~2744 (1993)
  30. Seynnes OR, "Early structural adaptations to unloading in the human calf muscles", Acta Physiol (Oxf), 193, pp.265~274 (2008)
  31. de Boer MD, "Time course of muscular, neural and tendinous adaptations to 23 day unilateral lower-limb suspension in young men", J Physiol, 583(Pt 3), pp.1079~1091 (2007)
  32. de Boer MD, "Effect of 5 weeks horizontal bed rest on human muscle thickness and architecture of weight bearing and nonweight bearing muscles", Eur J Appl Physiol, 104, pp.401~407 (2008)
  33. Cosgrove AP, "Botulinum toxin A prevents the development of contractures in the hereditary spastic mouse", Dev Med Child Neurol, 36, pp.379~385 (1994)

관련 논문AI추천

Comparison of Treatment Effects Between Children With Spastic Cerebral Palsy Under and Over Five Years After Botulinum Toxin Type A Injection권동락, Gi-Young Park, Won-Yub Lee대한재활의학회 · Annals of Rehabilitation Medicine2014 · 제38권 제2호The Change of Intrinsic Stiffness in Gastrocnemius after Intensive Rehabilitation with Botulinum Toxin A Injection in Spastic Diplegic Cerebral Palsy권동락, 박기영, Jung Gu Kwon대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제3호Estimation of Gastrocnemius Muscle Volume Using Ultrasonography in Children with Spastic Cerebral Palsy나동욱, 박은숙, 심은결, 정수진연세대학교의과대학 · Yonsei Medical Journal2014 · 제55권 제4호Short-Term Effect of Botulinum Toxin A Injection on Spastic Equinovarus Foot in Cerebral Palsy Patients: A Study Using the Foot Pressure Measurement System박인식, 손수민, 유진선대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제1호Short-Term Effects of Combined Serial Casting and Botulinum Toxin Injection for Spastic Equinus in Ambulatory Children with Cerebral Palsy김선미, 나동욱, 박은숙, 송상혁, 유준기, 장원혁연세대학교의과대학 · Yonsei Medical Journal2010 · 제51권 제4호Therapeutic Effect of Extracorporeal Shock Wave Therapy According to Treatment Session on Gastrocnemius Muscle Spasticity in Children With Spastic Cerebral Palsy: A Pilot Study권동락, 박기영, 박동순, Michael Y. Lee대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제6호

이 간행물의 다른 논문 (17건)