Skeletal muscle stiffness and contracture in children with spastic cerebral palsy.

摘要

It is generally well known that upper motor neuron lesion, as may occur after a stroke, leads to impairment of voluntary muscle function and development of increased tone or spasticity in the affected skeletal muscles. The increased muscle tone, or resistance to passive stretch, is at least initially caused by exaggerated stretch reflexes (Buller, 1957; Crenna, 1998). More recent findings, however, have indicated that muscle spasticity resulting from upper motor neuron lesion in general may be rather more complex and may involve other changes in the skeletal muscle system, such as the extracellular matrix or the cyto-skeleton. In a recent issue of The Journal of Physiology, Srnith era/. (2011) indeed report some definitive, wide ranging and interesting experimental data from hamstring muscles of children with spastic cerebral palsy, an upper motor neuron lesion in the developing brain, that indicate that changes in the extracellular matrix of muscle, rather than changes within muscle fibres, contribute to increased stiffness and contracture in spastic muscle.