Usefulness of point shear wave elastography to assess the effects of extracorporeal shockwaves on spastic muscles in children with cerebral palsy: an uncontrolled experimental study

Abstract

Cerebral palsy (CP) comprises a group of neurological disorders resulting from malformation in the developing brain or nonprogressive brain injury occurring during or soon after birth. CP is the most common childhood disability, with a reported prevalence of 2-3 per 1000 live births (1). Physical disability in CP is mainly due to motor impairment, and manifests as poor muscle control, weakness, hypertonicity, spasticity, and balance disorders. The motor impairment frequently leads to contractures of muscle-tendon units with consequent reduction of the range of motion (RoM) of joints. Contracture most commonly affects the ankle plantar flexors, leading to equinus foot deformity. Contractures are not solely due to muscle overactivation; increased intrinsic passive stiffness of the tissue also contributes (2). Thus, increased muscle stiffness in CP has two components: active and passive. Active (neural) muscle stiffness is mainly related to spasticity, which is due to velocity-dependent exces-