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The change of intrinsic stiffness in gastrocnemius after intensive rehabilitation with botulinum toxin a injection in spastic diplegic cerebral palsy.

Kwon DR, Park GY, Kwon JG - Ann Rehabil Med (2012)

Bottom Line: A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP) children did not change the intrinsic stiffness.Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modified Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP.Additionally, we indentified decreased muscle stiffness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu 705-718, Korea.

ABSTRACT
A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP) children did not change the intrinsic stiffness. Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modified Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP. Additionally, we indentified decreased muscle stiffness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.

No MeSH data available.


Related in: MedlinePlus

Sonoelastographic image presentation of local muscle stiffness superimposed on the longitudinal B-mode ultrasound image of the right medial gastrocnemius (GCM) muscle at 4 weeks intensive rehabilitation treatment with BTX-A injection. (A) Sonoelastographic image (right) showed purple to green coloring (arrow). (B) Strain ratio between gastrocnemius and soleus muscles demonstrated 2.04. (C, D) Shear velocity in the medial GCM muscle and soleus muscle region revealed 1.97 m/s and 1.85 m/s, respectively.
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Figure 2: Sonoelastographic image presentation of local muscle stiffness superimposed on the longitudinal B-mode ultrasound image of the right medial gastrocnemius (GCM) muscle at 4 weeks intensive rehabilitation treatment with BTX-A injection. (A) Sonoelastographic image (right) showed purple to green coloring (arrow). (B) Strain ratio between gastrocnemius and soleus muscles demonstrated 2.04. (C, D) Shear velocity in the medial GCM muscle and soleus muscle region revealed 1.97 m/s and 1.85 m/s, respectively.

Mentions: Dynamic sonoelastography was displayed as a color-coded graphic representation and strain ratio between the gastrocnemius and soleus muscles of the relative stiffness of structures within the selected region of interest (ROI, 5×5 mm square). The local shear wave propagation velocity was then measured locally in the ROI (Fig. 1, 2). Purple indicated soft, green and yellow indicated intermediate stiffness, and red indicated hard. The elastic pattern in the medial GCM muscle was graded semiquantitatively on the dynamic sonoelastography as follows: 1 (purple to green: soft), 2 (green to yellow), 3 (yellow to red) and 4 (red: hard).3


The change of intrinsic stiffness in gastrocnemius after intensive rehabilitation with botulinum toxin a injection in spastic diplegic cerebral palsy.

Kwon DR, Park GY, Kwon JG - Ann Rehabil Med (2012)

Sonoelastographic image presentation of local muscle stiffness superimposed on the longitudinal B-mode ultrasound image of the right medial gastrocnemius (GCM) muscle at 4 weeks intensive rehabilitation treatment with BTX-A injection. (A) Sonoelastographic image (right) showed purple to green coloring (arrow). (B) Strain ratio between gastrocnemius and soleus muscles demonstrated 2.04. (C, D) Shear velocity in the medial GCM muscle and soleus muscle region revealed 1.97 m/s and 1.85 m/s, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3400881&req=5

Figure 2: Sonoelastographic image presentation of local muscle stiffness superimposed on the longitudinal B-mode ultrasound image of the right medial gastrocnemius (GCM) muscle at 4 weeks intensive rehabilitation treatment with BTX-A injection. (A) Sonoelastographic image (right) showed purple to green coloring (arrow). (B) Strain ratio between gastrocnemius and soleus muscles demonstrated 2.04. (C, D) Shear velocity in the medial GCM muscle and soleus muscle region revealed 1.97 m/s and 1.85 m/s, respectively.
Mentions: Dynamic sonoelastography was displayed as a color-coded graphic representation and strain ratio between the gastrocnemius and soleus muscles of the relative stiffness of structures within the selected region of interest (ROI, 5×5 mm square). The local shear wave propagation velocity was then measured locally in the ROI (Fig. 1, 2). Purple indicated soft, green and yellow indicated intermediate stiffness, and red indicated hard. The elastic pattern in the medial GCM muscle was graded semiquantitatively on the dynamic sonoelastography as follows: 1 (purple to green: soft), 2 (green to yellow), 3 (yellow to red) and 4 (red: hard).3

Bottom Line: A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP) children did not change the intrinsic stiffness.Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modified Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP.Additionally, we indentified decreased muscle stiffness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu 705-718, Korea.

ABSTRACT
A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP) children did not change the intrinsic stiffness. Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modified Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP. Additionally, we indentified decreased muscle stiffness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.

No MeSH data available.


Related in: MedlinePlus