Spasticity as part of a central neurological disorder is characterized by a ‘velocity dependent hyperactive stretch-reflex’ . Secondary, morphological adaptations of the muscle-tendon complex reduce the passive joint angle-moment relationship (i.e. passive ROM) . Potentially, joint hyper-resistance, as a result of either the neurological disorder, muscle morphology or both, can be clinically assessed . Botulinum Toxin-A (BoNT-A), in combination with casting and physiotherapy are regularly used as conservative treatment in children with a spastic paresis to improve gait. While in some studies improvements resulting from this approach are reported, large treatment response variability persists . Heterogeneity in treatment effectiveness may be due to a clinical focus at the joint impairment level rather than on the contributing mechanisms of joint hyper-resistance. In recent years great advances have been made in standardized, objective assessments of stretch reflexed induced joint hyper resistance . 3D ultrasound (3DUS), allows morphometry of the muscle-tendon complex in children with spastic paresis . The combination of instrumented assessments of neurological, muscle morphology and gait characteristics following treatment has not been carried out.
|Journal||Gait & Posture|
|Issue number||Supplement 1|
|Publication status||Published - 2017|
|Event||26th Annual Meeting of the European Society for Movement analysis in Adults and Children (ESMAC 2017) - Trondheim, Norway|
Duration: 6 Sep 2017 → 9 Sep 2017