Massage can increase the passive stiffness of spastic muscle in cerebral palsy

King's College London (2005) J Physiol 565P, C105

Communications: Massage can increase the passive stiffness of spastic muscle in cerebral palsy

Gladden, MH ; Macgregor, R ; Tennant, N ; Young, D ; Campbell, R ;

1. Institute of Biological and Life Sciences, Glasgow University, Glasgow, United Kingdom. 2. Royal Hospital for Sick Children, Glasgow, United Kingdom. 3. Strathclyde University, Glasgow, United Kingdom.

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Spastic muscles in cerebral palsy were thought to be intrinsically stiffer than normal. However, direct assessment of mechanical properties showed that whereas the muscle fibres are stiffer, the surrounding connective tissue is much more compliant (Lieber et al., 2004). Muscle architecture is disordered (Shortland et al., 2002). We tested whether massage stretching spastic muscles mainly transversely rather than longitudinally could increase the range of movement. Calf muscles of 5 adolescents with spastic diplegia were massaged for 14 minutes twice weekly for 5 weeks. The adolescents gave their informed consent; permission for the study was obtained from their parents and doctors, the local Ethics Committee and Education Authority. The ankles were dorsiflexed 3 times before and after massage by an experimenter attempting to apply force at a constant rate of about 8Ns-1 by following a template on a computer screen. The change in angle at the ankle, force applied and EMG of the soleus muscle were recorded. After massage the angles reached by dorsiflexing the ankles were not consistently increased, but surprisingly, the pressure required was significantly incresed in all 10 limbs (P95% confidence intervals for one participant). The 5th adolescent who cannot move his ankles voluntarily did not improve his score. This suggests that adaptation can occur providing there is some voluntary control.



Where applicable, experiments conform with Society ethical requirements.

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