Relationship of muscle morphology to hip displacement in cerebral palsy: a pilot study investigating changes intrinsic to the sarcomere

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dc.contributor.authorLarkin-Kaiser, Kelly A
dc.contributor.authorHoward, Jason J
dc.contributor.authorLeonard, Timothy
dc.contributor.authorJoumaa, Venus
dc.contributor.authorGauthier, Luke
dc.contributor.authorLogan, Karl
dc.contributor.authorOrlik, Benjamin
dc.contributor.authorEl-Hawary, Ron
dc.contributor.authorHerzog, Walter
dc.date.accessioned2019-06-23T00:12:50Z
dc.date.available2019-06-23T00:12:50Z
dc.date.issued2019-06-21
dc.date.updated2019-06-23T00:12:50Z
dc.description.abstractAbstract Background Cerebral palsy (CP) is the most common cause of childhood disability, typified by a static encephalopathy with peripheral musculoskeletal manifestations—most commonly related to spasticity—that are progressive with age. Hip displacement is one of the most common manifestations, observed to lead to painful degenerative arthritis over time. Despite the key role that spasticity-related adductor muscle contractures are thought to play in the development of hip displacement in CP, basic science research in this area to date has been limited. This study was initiated to correlate hip adductor muscle changes intrinsic to the sarcomere—specifically, titin isoforms and sarcomere length—to the severity of hip displacement in children with spastic cerebral palsy. Methods Single gracilis muscle biopsies were obtained from children with CP (Gross Motor Function Classification System (GMFCS) III-V; n = 10) who underwent adductor muscle release surgery for the treatment of hip displacement. Gel electrophoresis was used to estimate titin molecular weight. Sarcomere lengths were measured from muscle fascicles using laser diffraction. The severity of hip displacement was determined by measuring by Reimers migration percentage (MP) from anteroposterior pelvic x-rays. Correlation analyses between titin, sarcomere lengths, and MP were performed. Results The mean molecular weight of titin was 3588 kDa. The mean sarcomere length was 3.51 μm. Increased MP was found to be associated with heavier isoforms of titin (R2 = 0.65, p < 0.05) and with increased sarcomere lengths (R2 = 0.65, p < 0.05). Heavier isoforms of titin were also associated with increased sarcomere lengths (R2 = 0.80, p < 0.05). Conclusions Our results suggest that both larger titin isoforms and sarcomere lengths are positively correlated with increased severity of hip displacement and may represent adaptations in response to concomitant increases in spasticity and muscle shortening. Trial registration As this study does not report the results of a health care intervention on human participants, it has not been registered.
dc.identifier.citationJournal of Orthopaedic Surgery and Research. 2019 Jun 21;14(1):187
dc.identifier.doihttps://doi.org/10.1186/s13018-019-1239-1
dc.identifier.urihttp://hdl.handle.net/1880/110521
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titleRelationship of muscle morphology to hip displacement in cerebral palsy: a pilot study investigating changes intrinsic to the sarcomere
dc.typeJournal Article
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