Effect of performing daily activities while standing on the quantity and quality of the thigh muscles in adults with severe cerebral palsy: a cross-sectional study.
Soma Endo, Toshikazu Soyama, Hitoshi Asai and 4 others
PMID 33814718WHAT IT FOUND
In adults with severe cerebral palsy, those who stood daily during care had thicker quadriceps and higher gross motor function scores.
However, they also showed higher muscle echo intensity, suggesting more fat or connective tissue within the muscle. Standing may change muscle quality, not just strength.
Key findings
01Adults who stood daily had significantly thicker quadriceps muscles than those who did not.
02Higher gross motor function scores were associated with higher echo intensity in the rectus femoris, contrary to the expectation that better function means less muscle fat.
03The correlation between gross motor function and muscle thickness disappeared when looking only at the group that stood daily.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small, especially after dividing participants into standing and non-standing groups (10 vs 23), which reduced statistical power. The study was cross-sectional, so it cannot prove that standing caused the muscle changes or that the changes were due to standing rather than other factors. Previous standing interventions were not tracked, so it is unclear how long participants had been standing or what type of standing they performed. The results apply only to adults with severe CP (GMFCS IV and V) who cannot walk independently; they may not generalize to those with milder CP. The group that stood did so with assistance or handrails and often with flexed knees, which places a different type of load on the muscle than independent standing.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that the observed changes in muscle echo intensity are negative. The authors state that it is not possible to draw definitive conclusions about whether these qualitative muscle changes are beneficial or harmful. The higher echo intensity in the standing group might reflect adaptation to load rather than pathology.