Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-07-08T03:03:54.759Z Has data issue: false hasContentIssue false

Changes to medial gastrocnemius architecture after surgical intervention in spastic diplegia

Published online by Cambridge University Press:  11 October 2004

Adam P Shortland
Affiliation:
One Small Step Gait Laboratory, Guy's Hospital, London, UK.
Nicola R Fry
Affiliation:
One Small Step Gait Laboratory, Guy's Hospital, London, UK.
Linda C Eve
Affiliation:
One Small Step Gait Laboratory, Guy's Hospital, London, UK.
Martin Gough
Affiliation:
One Small Step Gait Laboratory, Guy's Hospital, London, UK.
Get access

Abstract

We assessed the architecture of the medial gastrocnemius in nine children (five males, four females; age range 6 to 15 years; mean 10 years 10 months, SD 3 years 6 months) with spastic diplegia by ultrasound imaging before and after a gastrocnemius recession. The children were ambulant (seven independent, one with a posterior walker, one using crutches) before and after surgical intervention. We compared values for fascicle lengths and deep fascicular-aponeurosis angles with those from a group of normally developing children (five males, five females; age range 6 to 11 years; mean 8 years 4 months, SD 1 year 4 months). Despite a variable interval between assessments (from 56 to 610 days), fascicles were shorter (p=0.00226) and the deep fascicular-aponeurosis angle increased (p=0.0152) after intervention. Fascicle lengths of patients were similar to those in the group of normally developing children before surgery. After surgery, fascicles in the group of children with spastic diplegia were shorter than in their normally developing peers (p=0.00109). The gastrocnemius recession procedure alters muscle architecture, though the degree of fascicular shortening varied, with four of the participants in our study losing less than 10% of their original fascicular length at maximum dorsiflexion. Increases in ankle-joint power in walking, observed after surgical intervention in children with spastic diplegia, may be due to a more normal ankle position rather than to improvements in the active mechanical performance of the gastrocnemius.

Type
Original Articles
Copyright
© 2004 Mac Keith Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)