Session Information
Date: Tuesday, June 21, 2016
Session Title: Spasticity
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: We aimed to address spastic muscle behavior under dynamic conditions in children with hereditary spastic paraplegia (HSP).
Background: HSPs are a clinically and genetically heterogeneous group of conditions characterized by the presence of lower limb spasticity and pyramidal weakness. Very little is known about spastic muscle behavior under dynamic conditions and its correlation with the energetic expenditure.
Methods: Ten children (3 male; age range: 4-13 years) were enrolled in the study and evaluated clinically by means of the Spastic Paraplegia Rating Scale (SPRS). Spastic muscle (soleus) behavior was quantitatively characterized by the level of EMG activity as a function of the muscle lengthening velocity (muscle kinematics was estimated by geometrical models) during at least 5 trials of unperturbed overground walking. For all subjects, we calculated the Energy Recovery index (ER), which indicates the extent of mechanical energy reutilization through the shift between gravitational potential energy and kinetic energy. It can be assumed as a global measurement of functional gait and it ranges, in healthy subjects, between 65% and 75% (on average, within step).
Results: We identified four different patterns of spastic muscle behavior. Pattern-I was defined by the presence of hyper-synchronous activity in the post heel-contact phase with equal or higher amplitude with respect to the following push-off phase (and no activity pause between these two phases). We classified pattern-II or -III when the hyper-synchronous activity in the post heel-contact phase (as in pattern-I) was paused by “Post Synchronous Discharge Silent Periods (PSDSPs)” >70ms (pattern-III if PSDSPs were n>3). Pattern-IV was characterized by hyper-synchronous activity also in the swing phase. Each child showed a different combination of these patterns. The maximal recovery values were overall reduced by 24% (on average) in all but two subjects. A positive correlation was found between recovery and % of normal strides.
Conclusions: A dynamic evaluation allowed a detailed profiling of spasticity in children with HSP. This might be useful to determine functional severity of lower limb spasticity for proper medical treatment.
To cite this abstract in AMA style:
V. Maltese, S. Klebe, A. Marzegan, M. Dipaola, J. Volkmann, C.A. Frigo, P. Cavallari, I.U. Isaias. Spastic gait and mechanical energy recovery in children with hereditary spastic paraplegia [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/spastic-gait-and-mechanical-energy-recovery-in-children-with-hereditary-spastic-paraplegia/. Accessed May 18, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/spastic-gait-and-mechanical-energy-recovery-in-children-with-hereditary-spastic-paraplegia/