The Use of Hand-Held Dynamometry for Measuring the Effect of Short-Leg Tone Reducing Casts on the Passive Compliance of Calf Muscles in Children with Cerebral Palsy

Abstract

The purpose of this study was to examine the use of a hand-held dynamometer in measuring the effect of short-leg tone reducing casts (STRC) on the compliance of calf muscles to passive stretch in CP children and to assess the reliability of this technique in terms of intertester agreement. STRCs were fitted to thirteen children suffering from CP for a period of three weeks. Three measurements were taken independently by two physical therapists: before casting, immediately after cast removal, and one month later. Each child was measured twice: in prone and supine positions. There was a significant (p < 0.01) increase in muscle compliance immediately after removing the casts, but the overall effect tended to diminish after one month. Intertester agreement was high as shown by intraclass correlation coefficients, which ranged from 0.89 to 0.95, thus supporting the application of this technique for assessing the status and variations of passive muscle compliance in CP children.

Keywords

Dynamometry Muscle compliance CP.

References

Cusick B. , Sussman MD Short-leg casts: their role in the management of cerebral palsy. Phys Occup Ther Pediatr 1982;2:93-115.

Sussman MD Casting as an adjunct to neurodevelopmental therapy for cerebral palsy . Dev Med Child Neurol 1983;25:804-5.

Tardieu C. , Huet de la Tour E, Bret MD, Tardieu G. Muscle hypoextensibility in children with cerebral palsy: I. Clinical and experimental observations. Arch Phys Med Rehab 1982;63:97-102.

Tardieu G. , Tardieu C. , Colbeau-Justin P. , Lespargot A. Muscle hypoextensibility in children with celebral palsy: II Therapeutic implications . Arch Phys Med Rehab 1982;63:103-7.

Otis JC , Root L. , Pamilla JR , Kroll MA Biomechanical measurement of spastic plantar flexors. Dev Med Child Neurol 1983;25:60-66.

Otis JC , Root L. , Kroll M. Measurement of plantar flexor spacticity during treatment with tone reducing casts. J Pediatr Orthop 1985;5:682-86.

Kasser JR

Examination of the cerebral palsy patient with foot and ankle problems. Ankle and

Foot 1983;4:149-55.

Fontenrose A. , Miller J. Physicians and physical therapists evaluations of cerebral palsy children for Achilles tendon lengthening. Dev Med Child Neurol 1984;26:208-13.

Dvir Z, Bar Haim S, Arbel N. Intertester agreement in static resistance measurement using a simple uniaxial dynamometer. Phys Occup Ther Pediatr 1990;10:59-67.

10.

Shrout PE , Fleiss JL Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979;86:420-28.

11.

Bertoti DB Effect of short leg casting on ambulation in children with cerebral palsy . Phys Ther 1986;66:1522-29.

12.

Riddle DL Finucane SD, Rothstein JM, Walker ML. Intrasession and intersession reliability of hand-held dynamometer measurements taken on brain-damaged patients . Phys Ther 1989,-69:82-89.