Rapid force generation is impaired in cerebral palsy and is related to decreased muscle size and functional mobility

Abstract

Limb movements involving contraction times of 50-200 ms occur in many everyday activities, such as gait, which is faster than the time required to generate maximal force. Therefore, the ability to rapidly produce force may be even more important for the performance of functional activities. In this study rate of force development (RFD) and impulse of the knee extensors were examined in 12 ambulatory children with cerebral palsy (CP) (age: 11.9 ± 2.9 years) and 11 with typical development (TD) (Age: 11.3 ± 3.0 years). The relationship with muscle architecture and functional mobility was also determined. RFD and impulse were calculated during a maximal isometric knee extension contraction. Rectus femoris (RF) cross-sectional area and RF and vastus lateralis (VL) muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured using ultrasound imaging. Gait temporal-spatial parameters, Pediatric Outcomes Data Collection Instrument (PODCI), and Activities Scale for Kids performance version (ASKp) were collected. Although VL MT was the primary determinant of RFD and impulse in CP, FA and FL were also significant predictors in the TD group. RFD and impulse were significantly lower in CP compared to TD (70% decrease) in addition to maximal strength (50% decrease). RFD and impulse were predictive of measures of functional mobility, including gait, transfers, and sports and higher level activities but not temporal-spatial gait measures. Results suggest that the ability to rapidly generate torque may be of greater importance than maximal strength during certain tasks, such as transfers and sports and higher level activities.

Figure 1

RFD measures (mean ± SD) in the CP and TD groups are illustrated in Figure 1a. Impulse measures (mean ± SD) in the CP and TD groups are illustrated in Figure 1b. Differences between groups were statistically significant (p < 0.05).