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Rose J, McGill KC. The motor unit in spastic cerebral palsy. Developmental Medicine & Child Neurology, 40: 270-277, 1998.
Recent advances in the study of human walking have enhanced our understanding of gait disorders by providing quantitative analysis of kinematics, energetics, kinetics, and the timing of muscle contraction. Despite these advances, the contribution of spasticity and weakness to the movement deficit in cerebral palsy (CP) is not well understood. Although muscle weakness traditionally has not been recognized as a significant problem in patients with CP, several studies suggest that weakness may be an integral component of the movement deficit. Clinical observations indicate that muscle weakness and spasticity coexist in patients with CP and present major obstacles. An essential first step towards designing an effective treatment is a clear understanding of the underlying mechanisms, specifically, the role of the motor unit in the movement deficits of patients with CP. This paper reviews the structural and electrophysiological changes that take place in the motor unit in CP and in other related conditions, and reviews the clinical significance of these pathological changes. We are investigating the way in which the shapes of muscle action potentials are determined by anatomical and physiological factors. This is important for accurate clinical interpretation of clinically recorded signals.