High Velocity Passive Stretching Mimics Eccentric Exercise in Cerebral Palsy and May Be Used to Increase Spastic Muscle Fascicle Length

TL;DR

High-velocity passive stretching in cerebral palsy may increase muscle fascicle length similarly to eccentric exercise, without causing muscle damage.

Contribution

High-velocity passive stretching is shown to mimic eccentric exercise effects in spastic muscles of CP patients.

Findings

High-velocity passive stretching induced positive fascicle strain in the vastus lateralis.

Muscle deactivation occurred during stretching in CP participants, similar to eccentric exercise.

No muscle micro-damage was observed in either CP or non-CP participants after stretching.

Abstract

Muscle fascicles are shorter and stiffer than normal in spastic Cerebral Palsy (CP). Increasing fascicle length (FL) has been attempted in CP, the outcomes of which have been unsatisfactory. In healthy muscles, FL can be increased using eccentric exercise at high velocities (ECC). Three conditions are possibly met during such ECC: muscle micro-damage, positive fascicle strain, and momentary muscle deactivation during lengthening. Participants with and without CP underwent a single bout of passive stretching at (appropriately) high velocities using isokinetic dynamometry, during which we examined muscle and fascicle behaviour. Vastus lateralis (VL) FL change was measured using ultrasonography and showed positive fascicle strain. Measures of muscle creatine kinase were used to establish whether micro-damage occurred in response to stretching, but the results did not confirm damage in either group. Vastus medialis (VM) and biceps femoris muscle activity were measured using electromyography in those with CP. Results supported momentary spastic muscle deactivation during lengthening: all participants experienced at least one epoch (60 ms) of increased activation followed by activation inhibition/deactivation of the VM during knee flexion. We argue that high-velocity passive stretching in CP provides a movement context which mimics ECC and could be used to increase spastic FL with training.

Figures