Association of sagittal spinal alignment in the sitting position with the trunk and lower extremity muscle masses in children and adults with cerebral palsy: A pilot study |
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| Institution: | 1. Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, 501 Nakaorui-machi, Takasaki 370-0033, Japan;2. Department of Rehabilitation, Sannocho Hospital, Niigata, 5-2-30 Hon-cho, Sanjo 955-0071, Japan;3. Department of Rehabilitation, Hanna Sawarabi Ryoikuen, Gunma, 28-30 Harunasan-machi, Takasaki 370-3341, Japan;4. Suzuki Otolaryngology Clinic, Niigata, 6-5-37 Meike, Chuo-ku, Niigata 950-0941, Japan;5. Department of Rehabilitation, Takeda General Hospital, Fukushima, 3-27 Yamaga-machi, Aizuwakamatsu 965-8585, Japan;6. Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan;7. Department of Rehabilitation, Iwamuro Rehabilitation Hospital, Niigata, 772-1 Iwamuronsen, Nishikan-ku, Niigata 953-0104, Japan;8. Department of Rehabilitation, Tsunoda Hospital, Gunma, 675-4 Kamishinden, Tamamura-machi, Sawagun 370-1133, Japan;9. Tsutsumi Orthopaedic Clinic, Akita, 3-8-24 Terauchidonosawa, Akita 011-0901, Japan;10. Midori-no Kodomokan, Musashino City Development Support Center for Children, Tokyo, 2-6-8 Midori-cho, Musashino 180-0012, Japan;11. Department of Rehabilitation, Gunma Seishi Ryougoen, Gunma, 146-1 Ashikado-machi, Takasaki 370-3531, Japan;12. Department of Rehabilitation, Asahigawasou Rehabilitation & Medical Center, Okayama, 866 Gion, Kita-ku, Okayama 703-8555, Japan;1. MOTION Science Institute, University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB8700, Chapel Hill, NC 27599, USA;2. Human Movement Science Curriculum, University of North Carolina at Chapel Hill, CB8700, Chapel Hill, NC 27599, USA;1. Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany;2. Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;1. IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal;2. Hospital dos Lusíadas, Lisbon, Portugal |
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| Abstract: | BackgroundWe examined the association of sagittal spinal alignment in the sitting position with the trunk and lower extremity muscle masses in children and adults with cerebral palsy (CP). We also compared muscle masses between children and adults with CP who could and could not sit without the support of their upper extremities.MethodsThe subjects were 34 children and adults with CP. Sagittal spinal alignment in the sitting position, such as thoracic kyphosis, lumbar lordosis, and sacral anterior inclination angles were measured using a Spinal Mouse. The thicknesses of the trunk and lower extremity muscles were measured using an ultrasound imaging device. Furthermore, the subjects were classified into the sitting-possible group (n = 18), who could sit without the support of the upper extremities, or a sitting-impossible group (n = 16), who could not sit without the support of the upper extremities.FindingsStepwise regression analysis revealed that the lumbar multifidus muscle thickness and body weight were significant and independent factors of the lumbar lordosis angle in the sitting position. The thicknesses of the thoracic erector spinae, gluteus maximus and minimus, long head of the biceps femoris, semitendinosus, and rectus femoris muscles were significantly lower in the sitting-impossible group than those in the sitting-possible group.InterpretationDecreased lumbar lordosis angle in the sitting position was associated with decreased lumbar multifidus muscle mass in children and adults with CP. Furthermore, not only trunk extensor but also hip joint muscles may contribute to sitting without upper extremity support. |
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