Hamstring muscle length in ambulant children with spastic bilateral cerebral palsy: Development and physiotherapy treatment

Children with spastic bilateral cerebral palsy (CP) often develop muscle contractures and it appears to evolve by lower functional levels and age. Hamstring muscle shortening is one of several impairments developing during childhood and it often causes worsening of gait function. The thesis includes a longitudinal register-based cohort study including 419 ambulant children with CP (2193 tests), which revealed that the hamstring muscle shortened and the hamstring spasticity was low throughout childhood independent of gait function level. In a randomized controlled trial including 34 ambulant children (7-15 years of age) a 16-week muscle stretching and strength training program showed small but statistically insignificant effects on hamstrings muscle length in favor of the intervention group, but no effects on gait function. The findings indicate that clinicians should pay attention to maintaining the length of the hamstring muscle from an early age, independent of gait function level. The results from the intervention study indicate that a combination of muscle stretching and strength training might be helpful to prevent hamstring muscle shortening during childhood