Muscle weakness in cerebral palsy

Over the last two decades, muscle weakness has been shown to be a major component of cerebral palsy (CP) pathology. Caused by multiple etiologies including variations in the muscle fiber type, pathologic motor unit function, co-contraction of agonists and antagonists, and muscle size and rigidity, weakness interferes with function and leads to limited function and participation. Muscle strength was found to be associated with walking ability and with functional scales. Children with CP were found to be weaker than typically developing children, and differences were found with respect to muscle groups in children with CP. Muscle weakness should be evaluated as objectively as possible to improve the quality of diagnosis and treatment. Manual muscle testing is not sufficient for evaluation, and instrumented muscle testing is validated in CP. Muscle strengthening is an important part of treatment of CP. Several methods of strengthening have been described. Muscle lengthening and other spasticity-modifying therapies have been shown to have a positive effect on muscle strength. Children who participated in muscle strengthening programs had a better quality of life and improved function.