Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study

IntroductionSpasticity and altered muscle tone are key features in children with neurodevelopmental disorders, particularly cerebral palsy (CP). They impact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle...

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Main Authors: Ramón González-Matilla, Vanesa Abuín-Porras, Isabel Mínguez-Esteban, Alberto M. Heredia-Rizo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Physiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2025.1588084/full
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author Ramón González-Matilla
Ramón González-Matilla
Ramón González-Matilla
Vanesa Abuín-Porras
Isabel Mínguez-Esteban
Alberto M. Heredia-Rizo
Alberto M. Heredia-Rizo
Alberto M. Heredia-Rizo
author_facet Ramón González-Matilla
Ramón González-Matilla
Ramón González-Matilla
Vanesa Abuín-Porras
Isabel Mínguez-Esteban
Alberto M. Heredia-Rizo
Alberto M. Heredia-Rizo
Alberto M. Heredia-Rizo
author_sort Ramón González-Matilla
collection DOAJ
description IntroductionSpasticity and altered muscle tone are key features in children with neurodevelopmental disorders, particularly cerebral palsy (CP). They impact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle differences in children with CP can help improve clinical assessment and therapeutic interventions. This study aims to evaluate differences in muscle tone, stiffness, ROM, and pain perception between children with CP and typically developing peers using objective biomechanical measures.MethodsAn observational, cross-sectional study was conducted with 40 participants of both sexes (20 children with CP, 20 typically developing peers). Muscle tone and stiffness of the lower limb muscles were measured using the Myoton PRO device. ROM was assessed by goniometry, and pain perception was evaluated using the Visual Analog Scale during a Straight Leg Raise (SLR) test. A generalized linear mixed model was used to detect differences in myotonometry, ROM, and pain perception measurements. In participants with CP, the Pearson product-moment correlation coefficient analysis was used to explore possible associations between clinical features and muscle tone and stiffness.ResultsChildren with CP exhibited reduced ROM, with a significant group effect for hip flexion (P < 0.001; η2 = 0.843), knee extension (P < 0.001; η2 = 0.355), and ankle flexion (P < 0.001; η2 = 0.959) and higher pain perception during the SLR test (P < 0.001; η2 = 0.831), compared to controls. Myotonometry revealed significantly increased muscle stiffness of the rectus femoris (P = 0.004; η2 = 0.112) and adductor muscles (P = 0.019; η2 = 0.074) in the CP group, with no differences in muscle tone between the groups. Sex-related differences were found for muscle tone and stiffness, with males showing higher values. Correlation analyses indicated that adductor muscles stiffness was associated with CP severity.ConclusionChildren with CP demonstrate significant changes in ROM, pain perception, and muscle stiffness, emphasizing the need for targeted therapeutic interventions. These findings support the use of objective biomechanical tools for assessing muscle properties in clinical settings, contributing to better management strategies for spasticity-related impairments.
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spelling doaj-art-84cb84aa8adc41e286a91cf165b0f7232025-08-20T03:08:33ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-04-011610.3389/fphys.2025.15880841588084Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional studyRamón González-Matilla0Ramón González-Matilla1Ramón González-Matilla2Vanesa Abuín-Porras3Isabel Mínguez-Esteban4Alberto M. Heredia-Rizo5Alberto M. Heredia-Rizo6Alberto M. Heredia-Rizo7Departamento de Fisioterapia, Investigación y Deporte. Centro Universitario FISIDEC, Universidad de Córdoba, Córdoba, SpainCentro de Atención Infantil Temprana, Universidad de Córdoba, Córdoba, SpainCTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, SpainDepartment of Physiotherapy, Universidad Europea de Madrid, Faculty of Medicine, Health and Sports, Villaviciosa de Odón, SpainDepartment of Physiotherapy, Universidad Europea de Madrid, Faculty of Medicine, Health and Sports, Villaviciosa de Odón, SpainCTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, SpainInstituto de Biomedicina de Sevilla, IBiS (Hospitales Universitarios Virgen del Rocío y Macarena/CSIC/Universidad de Sevilla), Sevilla, SpainDepartamento de Fisioterapia, Universidad de Sevilla, Sevilla, SpainIntroductionSpasticity and altered muscle tone are key features in children with neurodevelopmental disorders, particularly cerebral palsy (CP). They impact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle differences in children with CP can help improve clinical assessment and therapeutic interventions. This study aims to evaluate differences in muscle tone, stiffness, ROM, and pain perception between children with CP and typically developing peers using objective biomechanical measures.MethodsAn observational, cross-sectional study was conducted with 40 participants of both sexes (20 children with CP, 20 typically developing peers). Muscle tone and stiffness of the lower limb muscles were measured using the Myoton PRO device. ROM was assessed by goniometry, and pain perception was evaluated using the Visual Analog Scale during a Straight Leg Raise (SLR) test. A generalized linear mixed model was used to detect differences in myotonometry, ROM, and pain perception measurements. In participants with CP, the Pearson product-moment correlation coefficient analysis was used to explore possible associations between clinical features and muscle tone and stiffness.ResultsChildren with CP exhibited reduced ROM, with a significant group effect for hip flexion (P < 0.001; η2 = 0.843), knee extension (P < 0.001; η2 = 0.355), and ankle flexion (P < 0.001; η2 = 0.959) and higher pain perception during the SLR test (P < 0.001; η2 = 0.831), compared to controls. Myotonometry revealed significantly increased muscle stiffness of the rectus femoris (P = 0.004; η2 = 0.112) and adductor muscles (P = 0.019; η2 = 0.074) in the CP group, with no differences in muscle tone between the groups. Sex-related differences were found for muscle tone and stiffness, with males showing higher values. Correlation analyses indicated that adductor muscles stiffness was associated with CP severity.ConclusionChildren with CP demonstrate significant changes in ROM, pain perception, and muscle stiffness, emphasizing the need for targeted therapeutic interventions. These findings support the use of objective biomechanical tools for assessing muscle properties in clinical settings, contributing to better management strategies for spasticity-related impairments.https://www.frontiersin.org/articles/10.3389/fphys.2025.1588084/fullcerebral palsymuscle stiffnessspasticitypain perceptionmyotonometry
spellingShingle Ramón González-Matilla
Ramón González-Matilla
Ramón González-Matilla
Vanesa Abuín-Porras
Isabel Mínguez-Esteban
Alberto M. Heredia-Rizo
Alberto M. Heredia-Rizo
Alberto M. Heredia-Rizo
Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
Frontiers in Physiology
cerebral palsy
muscle stiffness
spasticity
pain perception
myotonometry
title Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
title_full Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
title_fullStr Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
title_full_unstemmed Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
title_short Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
title_sort biomechanical and clinical differences in muscle tone stiffness range of motion and pain perception in children with cerebral palsy a cross sectional study
topic cerebral palsy
muscle stiffness
spasticity
pain perception
myotonometry
url https://www.frontiersin.org/articles/10.3389/fphys.2025.1588084/full
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