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Geschiedenis en hulpwetenschappen --- Histoire et sciences auxiliaires --- Geschiedenis der middelecuwen --- Histoire du moyen âge --- 9 (...) " 04 : 15 " (07)

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Beschavingsgeschiedenis --- Civilisation --- Histoire universelle --- Wereldgeschiedenis --- 9 (88) " 1648 : 1951 "

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Cerebral palsy (CP) is the most common physical disability in childhood, with a prevalence of 1 in every 500 newborn children. It is characterized by a non-progressive brain injury and by secondary musculoskeletal disabilities which can further aggravate with age despite the brain injury being static. Children with CP are classified using the Gross Motor Classification System (GMFCS), depending on how their functional abilities are they are divided into group I, II, III, IV or V. Musculoskeletal impairments are spasticity - occurring in 75% of all CP patients -, muscle weakness and impaired functional ability which can all further develop into muscle contractures and reduced range of motion. Most treatment modalities are mainly focused on the muscle. So far, microscopic data on the muscle properties and muscle growth in young children with CP and age-matched typically developing (TD) children are very scarce. The aim of this study the aim was to compare skeletal muscle architecture via histological assessments in young children with CP at an early stage of the brain injury with age-matched TD children to have a better understanding of the alterations occurring in the muscle in children with CP. The hypothesis in this study was that skeletal muscle alterations are already present in a very early stage of the pathology. Skeletal muscle micro biopsies were collected from the medial gastrocnemius (MG) in 21 children with CP (age range 2-6; GMFCS levels I-III) and 12 TD children (age range 2-6). Exclusion criteria for children with CP include presence of dystonia or ataxia, botulinum toxin injections within the last 6 months, orthopedic surgery, muscle surgery on the MG within the last 2 years, for TD children include a history with neurological problems. The biopsies were taken under general anesthesia using minimal invasive sonographically guided percutaneous micro biopsy needle technique. Sections of the micro biopsies were stained with 1) hematoxylin & eosin to assess general muscle structure quality; 2) myosin heavy chain (MHC-I, -IIa and -IIx) for analyzing cross-sectional area of the muscle fiber types; 3) Pax7 to determine the amount of satellite cells (SC)/100 fibers; 4) CD-31 to quantify the capillary density (CD) and the capillary-to- fiber ratio (C:F), to have an overall view capillarization of the muscle in CP children. All parameters were compared between the TD children and CP children and a comparison grouped per GMFCS level, using (non-)parametric Mann-Whitley or student t-test and a one-way ANOVA test or a Kruskal-Wallis test, respectively. The size of the type I and type IIa fibers were significantly reduced in children with CP especially those with GMFCS level III compared to TD children and CP children with GMFCS level I. The proportion of the type IIx fiber was increased in all GMFCS levels compared to TD children. Satellite cells tended to be reduced in number in children with CP while CD and the C:F were significantly lower in children ix with CP compared to TD children. These results indicate that muscle properties are already altered in very young CP children and especially in CP children with GMFCS level III.