Spasticity reduction in children with cerebral palsy is not associated with reduced energy consumption during walking

BackgroundThe average energy consumption during walking of children with cerebral palsy (CP) is over two times of that of typically developing (TD) children and fatigue is one of the top complaints of children with CP and their families. Spasticity has been theorized to contribute to increased energy consumption during walking in CP, but its role remains unclear.\n\nMethodsWe retrospectively compared the energy consumption of walking in children with diplegic CP before and after selective dorsal rhizotomy (SDR), a surgery that reduces spasticity. A control group of participants with CP who also underwent gait analysis but did not undergo SDR was matched to the SDR group by pre-surgery age, spasticity, and energy consumption. Energy consumption and spasticity were compared at baseline and follow-up for both groups.\n\nFindingsAs expected, the SDR group has a significantly greater decrease (-44%) in spasticity compared to matched peers with CP who did not undergo SDR (-16%, P<0.001). While both groups had a reduction in energy consumption between visits (12 % SDR and 14% no-SDR), there was no difference in the change in energy consumption between groups (P=0.4).\n\nInterpretation: Reducing spasticity did not contribute to greater reductions in energy consumption, suggesting that spasticity has minimal impact on elevated energy consumption during walking for children with CP. Energy consumption and spasticity decrease with age among children with CP. Identifying matched control groups of peers with CP is critical for research involving children with CP to account for changes due to development.\n\nHighlightsO_LIEnergy consumption is not reduced after rhizotomy compared to matched peers\nC_LIO_LISpasticity has minimal contribution to elevated energy during walking\nC_LIO_LIMatched control groups are critical in cerebral palsy research\nC_LI