Molenaars, J. (Jeanine) (2013) Elektromyografische kenmerken van spierreacties tijdens de kniepeesreflex bij kinderen met een hoog risico op een Cerebrale Parese. thesis, Medicine.
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Abstract
Introduction: Cerebral palsy (CP) is a disorder caused by pre- and perinatal damage of the developing central nervous system. It is associated with impaired posture and motility. Early detection of CP remains difficult; therefore research on predictive factors is important. In the ongoing L2M 0-2 year study some high risk children showed a tonic response during the patellar tendon reflex. This reaction has not been described before. Therefore the present study was designed to explore the electromyographic characteristics of the tonic response in children at high risk for CP. The study’s secondary objective was to explore whether the tonic reaction was associated with the development of CP. In addition, the phenomena of reciprocal excitation and reflex irradiation were documented. Methods: In this explorative study, the first 16 high-risk children of the L2M 0-2 year project were included. Most children had a serious lesion of the brain. Until the age of 21 months they were four times assessed. Patellar tendon reflexes were elicited several times and EMG signals were recorded of various leg, trunk, neck and arm muscles. The EMG data were analyzed using the software program PedEMG. Special attention was paid to tonic activity of the quadriceps (agonist), reciprocal excitation in the antagonist, and irradiation of the reflex response to other muscles. Reference data were available of 9 healthy infants aged 1 and 3 months. Non-parametric statistics were used. Resultaten: Tonic activity in the agonist during the patellar tendon reflex was observed in both high-risk children and healthy neonates. The extent to which this reaction occured varied largely. The young high-risk infants with and without CP showed significant more tonic activity in the agonist at T0 than the healthy infants (median values: L2M infants with and without CP: 21% and 45%, healthy babies: 7-8%; p=0,005 and p=0.027) The occurrence of the tonic response was not associated with the development of CP. The duration of the tonic response was, however, associated with CP at 21 months; the duration of tonic activity was significant longer in the children with CP than that in the high-risk children without CP. This study also showed that high-risk infants often exhibit reciprocal excitation and reflex irradiation. Conclusie: A tonic response during the patellar tendon reflex occurs both in children with high-risk for CP and in healthy babies, but more often in the high-risk babies. The phenomenon is characterized by a large variability. The frequency of the tonic reaction was not associated with the development of CP. However, its duration was. The tonic response may, just as reciprocal excitation and reflex irradiation, be an expression of typical reflex activity in young children. Further research into the tonic reflex activity in healthy and high-risk children is needed to furnish more insight into this phenomenon.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Hadders-Algra, Prof. M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:59 |
| Last Modified: | 25 Jun 2020 10:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1914 |
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