Acoustic and electrical activities during voluntary isometric contraction of biceps brachii muscles in patients with spastic cerebral palsy.

This study was designed to compare electromyogram (EMG) and acoustic myogram (AMG) recordings of biceps brachii muscles in patients with spastic cerebral palsy (CP). The maximal voluntary contraction (MVC) in the CP group was approximately one half of that of the normal group even after being normalized by the muscle cross-sectional area (CSA) (18.6 - 5.9 kNm/m2 in CP, 37.3 +/- 2.9 kNm/m2 in normal). Both CP and normal groups demonstrated a progressive increase in the root mean squared values per unit muscle CSA in the EMG (RMSEMG/CSA) as well as in the AMG (RMSAMG/CSA) with increasing force up to 50% MVC. The increasing magnitude of the RMSEMG/CSA with force was not significantly different between two subject groups. However, all the levels of force resulted in significantly smaller RMSAMG/CSA in the CP group compared to the normal group. The ratios of RMSAMG to RMSEMG in the CP group (0.75 +/- 0.03 m/s2/mV) were significantly smaller than those in the normal group (1.37 +/- 0.07 m/s2/mV) at force levels above 30% MVC. These results suggest that motor disabilities in CP patients are caused not only by primary neural impairment but also by secondary deterioration in muscular contractile properties, probably resulting from muscle fiber atrophy. This appears to be more selective in fast twitch fibers.