The relevance of nerve mobility on function and activity in children with Cerebral Palsy

Petra Marsico, Amir Tal-Akabi, Hubertus J. A. van Hedel

In children with cerebral palsy (CP), stiffness, caused by contractile and non-contractile structures, can influence motor performance. This study sought to determine whether the nerve mobility had a relevant impact on motor performance in children with CP. We hypothesized that a positive Straight Leg Raise (SLR) test, as well as smaller SLR hip angle, would relate to lower leg muscle strength, reduced motor capacity and less motor performance in children with CP. We applied a cross-sectional analysis on data including SLR, leg muscle strength, Gross Motor Function Measure (GMFM-66) and number of activity counts during daily life from thirty children with CP (6-18 years). We performed receiver operating characteristics and correlation analyses. Positive SLR test could distinguish well between children with low versus high muscle strength and GMFM-66 scores. The SLR hip angle correlated significant with the level of disability and with muscle strength. The correlation with the GMFM-66 and the activity counts was fair. This study suggests that neural restriction of SLR is higher on functional and activity outcome than the measured SLR hip range of motion. Further studies should investigate weather improving nerve mobility can lead to an amelioration of function in children with CP.