Clinical efficacy analysis of "Tongluo" technique on gastrocnemius muscle hardness and muscle tone in children with spastic cerebral palsy using shear wave elastography / 国际生物医学工程杂志

ABSTRACT

Objective:To investigate the clinical effect of the "Tongluo" technique on gastrocnemius muscle hardness and muscle tone in children with spastic cerebral palsy (SCP) using shear wave elastography (SWE).Methods:Forty children with SCP who were treated at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to June 2021 were selected as the observation group and received the "Tongluo" technique intervention. At the same time, 20 normal children were selected as the control group, without any intervention. Compare the various indicators of the two groups at baseline and after 1.5 and 3 months of treatment, including Young’s modulus value of the medial gastrocnemius muscle at rest, the modified Ashworth scale (MAS) score, and the clinical spasm index (CSI) score. The changes in muscle tone and spasticity of SCP children before and after treatment were compared, and the differences in the Young’s modulus between MAS and CSI levels in SCP children as well as the correlation between MAS, CSI, and Young’s modulus were analyzed.Results:The difference in Young’s modulus values of the control group at baseline, after 1.5 and 3 months of treatment was not statistically significant (all P > 0.05). At baseline, after 1.5 and 3 months of treatment, Young’s modulus value, MAS score, and total CSI score gradually decreased in the observation group, and the differences obtained from pairwise comparisons were statistically significant (all P < 0.01). At the same intervention stage, Young’s modulus value of the observation group was higher than that of the control group, with a statistically significant difference ( P < 0.01). The MAS score results showed that Young’s modulus of the observation group increased with the increase in muscle tone, and there was a positive correlation between Young’s modulus and muscle tone ( P < 0.01), and the difference in Young’s modulus corresponding to different muscle tones was statistically significant ( P < 0.05). The CSI score results showed that the Young’s modulus of the observation group increased with the increase in spasticity degree, and there was a positive correlation between the Young’s modulus and muscle tone ( P < 0.01), and the difference in Young’s modulus corresponding to different spasticity degrees was statistically significant ( P < 0.05). Conclusions:The muscle hardness of children with SCP is higher than that of normal children. The "Tongluo" technique can effectively improve muscle hardness, reduce muscle tone, and effectively improve muscle spasticity in children with SCP. The principle may be related to adjusting the internal structure of muscles to reduce muscle hardness. The results of this study can guide clinical rehabilitation and evaluation.