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. 2021 Jun 17:4:1000062.
doi: 10.2340/20030711-1000062. eCollection 2021.

THE MUSCLE SHORTENING MANOEUVRE: APPLICABILITY AND PRELIMINARY EVALUATION IN CHILDREN WITH HEMIPLEGIC CEREBRAL PALSY: A RETROSPECTIVE ANALYSIS

Diego Longo  1 , Marco Lombardi  2 , Paolo Lippi  3 , Daniela Melchiorre  1 , Maria Angela Bagni  1 , Francesco Ferrarello  4
Affiliations

THE MUSCLE SHORTENING MANOEUVRE: APPLICABILITY AND PRELIMINARY EVALUATION IN CHILDREN WITH HEMIPLEGIC CEREBRAL PALSY: A RETROSPECTIVE ANALYSIS

Diego Longo et al. J Rehabil Med Clin Commun. .

Abstract

Introduction: Physiotherapy plays a key role in cerebral palsy rehabilitation, through addressing body function/structure deficits, minimizing activity limitations, and encouraging participation. The muscle shortening manoeuvre is an innovative therapeutic technique, characterized by the ability to induce changes in muscle strength in a short time.

Objective: To describe the applicability and estimate the effect of the muscle shortening manoeuvre applied to improve motor weakness and joint excursion of the ankle in children with hemiplegic cerebral palsy.

Methods: Nine children with hemiplegic cerebral palsy received 3 intervention sessions in one week. Muscle strength, passive and active range of motion were assessed before, during and after the training, and at 1-week follow-up.

Results: The children experienced an immediate increase in muscle strength and joint excursion of the ankle; the improvements were still present at follow-up after 7 days.

Conclusion: The muscle shortening manoeuvre may be an effective intervention to induce an immediate increase in muscle strength and range of motion of the ankle in children affected by hemiplegia due to cerebral palsy, thus promoting better physical functioning.

Keywords: ankle joint; cerebral palsy; continuous passive; motion therapy; muscle strength; physical therapy modalities; recovery of function.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Mechanical set-up of the device. Alternating pull and release induce oscillations of the platform, producing relative muscle lengthening followed by sudden shortening of ankle dorsi- and plantar-flexor muscles. The fast accelerations are applied while the ankle is subjected to a force acting in the opposite direction (tensile stress).
Fig. 2
Fig. 2
Change in muscle strength. (A) From left to right: median of the differences (kilograms) between T0 and T1, T0 and T2, T0 and T3, and T0 and T4 for each of the joint angle tested, respectively. The error bars represent the 95% confidence interval. (B) From left to right: individual differences (kilograms) between T0 and T1, T0 and T2, T0 and T3, and T0 and T4 for each of the joint angle tested, respectively. The horizontal lines indicate a difference of 0 and, only for plantar flexor strength, the ±MDC95 values. D: Dorsiflexor; np: neutral position; P: plantar flexor; pf: plantarflexion.
Fig. 3
Fig. 3
Change in range of motion of the ankle. AROM: active range of motion; PROM: passive range of motion. (A) From left to right: median of the differences (degrees) between T0 and T1, T0 and T2, T0 and T3, and T0 and T4. The error bars represent the 95% confidence interval. (B) From left to right: individual differences (degrees) between T0 and T1, T0 and T2, T0 and T3, and T0 and T4. The horizontal lines indicate a difference of 0 and the ±MDC95 values. AROM: active range of motion; PROM: passive range of motion.
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