Description:

Abstract

 In patients with cerebral palsy (CP), an insult to or malformation of the developing brain results in deficient muscle system development and significant structural abnormalities of the muscle and tendon units. The clinical picture of these muscular impairments involves spasticity, increased stiffness, and weakness, resulting in pathological gait and reduced gross motor function. Examples of treatment modalities directed at the muscle include muscle strengthening, stretching and selective tone reduction. Recent investigations highlight that muscle tone and architecture are responsive to treatment, but treatment response is muscle, and patient-specific. Therefore, clinical tools and evaluation protocols that objectively assess spasticity as well as morphological muscle and tendon properties should be implemented in routine clinical practice. This is needed to guide patient-specific selection of appropriate, rationalized treatment choices and to determine the impact of these treatments on muscle architecture, muscular impairments (spasticity, stiffness, and weakness) and function. In our presentation, we will provide an overview of the instrumented assessments of spasticity and muscle morphology developed at our research centres and highlight how these evaluation protocols can potentially be used in clinical decision-making.

Speaker Info

 Lynn Bar-On received her physiotherapy degree in Groningen, The Netherlands and first worked as a physiotherapist in Israel, the Netherlands, and for six months for an NGO in Calcutta, India, before obtaining a Master in Rehabilitation Sciences and Physiotherapy with a specialization in Pediatrics and a PhD in Biomedical Sciences from the Katholieke Universiteit (KU) Leuven. She is now funded by personal post-doctoral grants from the Flemish Research Foundation (FWO) and the Netherlands Organisation for Scientific Research (NWO). Francesco Cenni received his master degree in Biomedical Engineering (Bologna, Italy) and worked for four years as a research assistant at Rizzoli Orthopeadic institute in Bologna. In 2018, he obtained a PhD in Engineering Sciences from the KU Leuven entitled: ‘3D Freehand Ultrasound Data Acquisition and Processing to Obtain Clinically-relevant Muscle and Tendon Parameters in Static and Dynamic Conditions in Children with Spastic Cerebral Palsy’. Soon thereafter, he received a one-year post-doctoral grant from the KU Leuven to continue his research on ultrasound imaging in pathology. Lynn and Francesco are currently collaborating on a project in children with CP that aims to evaluate the response of muscle and tendon properties to treatment. They combine measurements of muscle tissue extensibility (dynamic ultrasound imaging) and muscle activation (EMG) during various passive and active conditions of gradually increasing complexity. These rich datasets are then used to personalize neuro-musculoskeletal models with subject and muscle-specific parameters. By doing so, they hope to unravel some of the pathological mechanisms that contribute towards impaired gait in children with CP in order to critically analyze and improve treatment outcome.