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Journal of the Korean Academy of Rehabilitation Medicine 2009;33(6):693-697.
Ultrasonographic Measurement of Gastrocnemius Muscle Thickness in Spastic Cerebral Palsy and Influencing Factors.
Koo, Hye Kyung , Yi, Tae Im , Kim, Joo Sup , Seo, In Seok , Huh, Won Seok , Shim, Jae Won
Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Korea. cyriax@empal.com
경직성 뇌성마비 환아에서 초음파상 비복근의 두께 및 영향인자
구혜경, 이태임, 김주섭, 서인석, 허원석, 심재원
분당제생병원 재활의학과
Abstract
Objective
To identify the thickness of gastrocnemius muscles (GCM) in normal children and children with spastic cerebral palsy using ultrasonography and to determine the influencing factors in order to increase the accuracy of intramuscular injection of botulinum toxin A.
Method
Fifty-six children with spastic cerebral palsy (Group A) with no fixed contractures or operation history were involved in this study and they were compared with normal children (Group B). Children lay prone and one examiner measured the thickness of medial and lateral GCM using ultrasonography. Relationship between GCM thickness and clinical variables (age, height, weight, body mass index (BMI), calf circumference, Gross Motor Function Classification System (GMFCS) level, spasticity, number of botulinum toxin injections) were determined with Pearson's correlation.
Results
The thickness of medial and lateral GCM were 78.06±14.66 mm, 66.90±12.23 mm respectively, in Group A, and 103.44±12.04 mm, 79.95±9.76 mm respectively, in Group B. Medial GCM were thicker than lateral GCM in both groups. The age, height, weight, BMI, calf circumference and the thickness of GCM were higher in Group B. In group A, weight, BMI, calf circumference showed positive correlations with the thickness of medial GCM and GMFCS showed negative correlation with the thickness of medial GCM.
Conclusion
To increase the accuracy of intramuscular injection of botulinum toxin A, we should keep in mind that the thickness of GCM may be influenced by several factors. Further controlled study including larger group is needed. (J Korean Acad Rehab Med 2009; 33: 693-697)
Key Words: Spastic cerebral palsy, Thickness, Gastrocnemius muscle


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