Clinical Research
Heterogeneity of muscle sizes in the lower limbs of children with cerebral palsy
Geoffrey G. Handsfield PhD,
Craig H. Meyer PhD,
Mark F. Abel MD,
Silvia S. Blemker PhD,
Geoffrey G. Handsfield PhD
Department of Biomedical Engineering, Health System, University of Virginia, P.O. Box 800759, Charlottesville, Virginia, 22908 USA
Search for more papers by this authorCraig H. Meyer PhD
Department of Biomedical Engineering, Health System, University of Virginia, P.O. Box 800759, Charlottesville, Virginia, 22908 USA
Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
Search for more papers by this authorMark F. Abel MD
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
Search for more papers by this authorCorresponding Author
Silvia S. Blemker PhD
Department of Biomedical Engineering, Health System, University of Virginia, P.O. Box 800759, Charlottesville, Virginia, 22908 USA
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, Virginia, USA
Correspondence to: S.S. Blemker; e-mail: [email protected]Search for more papers by this authorGeoffrey G. Handsfield PhD,
Craig H. Meyer PhD,
Mark F. Abel MD,
Silvia S. Blemker PhD,
Geoffrey G. Handsfield PhD
Department of Biomedical Engineering, Health System, University of Virginia, P.O. Box 800759, Charlottesville, Virginia, 22908 USA
Search for more papers by this authorCraig H. Meyer PhD
Department of Biomedical Engineering, Health System, University of Virginia, P.O. Box 800759, Charlottesville, Virginia, 22908 USA
Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
Search for more papers by this authorMark F. Abel MD
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
Search for more papers by this authorCorresponding Author
Silvia S. Blemker PhD
Department of Biomedical Engineering, Health System, University of Virginia, P.O. Box 800759, Charlottesville, Virginia, 22908 USA
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, Virginia, USA
Correspondence to: S.S. Blemker; e-mail: [email protected]Search for more papers by this authorDisclosure: C.H.M. and S.S.B. are co-founders of a start-up company specializing in image processing and analysis of musculoskeletal MRI data. G.G.H. was previously employed as an analyst for said company.
This work was funded by the UVA-Coulter Foundation Translational Research Partnership.
ABSTRACT
Introduction
Cerebral palsy (CP) is associated with reduced muscle volumes, but previous studies have reported deficits in only a small number of muscles. The extent of volume deficits across lower limb muscles is not known. This study presents an imaging-based assessment of muscle volume and length deficits in 35 lower limb muscles.
Methods
We imaged and segmented 35 muscles in 10 subjects with CP and 8 typically developing (TD) controls using MRI. Muscle volumes were normalized, and Z-scores were computed using TD data. Volume Z-scores and percent deficits in volume, length, and cross-sectional area are reported.
Results
Muscle volumes are 20% lower, on average, for subjects with CP. Volume deficits differ significantly between muscles (12%–43%) and display significant heterogeneity across subjects. Distal muscles, especially the soleus, are commonly and severely small.
Conclusions
Heterogeneity across muscles and across subjects reinforces the subject specificity of CP and the need for individualized treatment planning. Muscle Nerve 53: 933–945, 2016
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