Medial Gastrocnemius Muscle Properties of Children With Cerebral Palsy After Different Tone Treatments: A Pilot Study.

Only 4 eligible individuals were invited and 1 declined, leaving one participant per group. The study did not use a prospective controlled design and lacked age-matched controls, so it cannot establish cause and effect. The observed differences between the three participants should not be treated as between-group effects. Participants were not matched on sex, birth history, developmental milestones, topography, age at biopsy, contracture severity, or gait abnormality. The Minimal Tone and SDR participants each had two BoNT-A injections in early childhood, so the groups did not strictly represent one method of tone management. The sample was a convenience sample of individuals undergoing surgery, which limits generalizability. No objective measures of physical activity were collected, and physical activity is related to muscle quality. The biopsy was taken relatively close to the musculotendinous junction, where collagen may be higher and capillary density may be lower, complicating comparisons with other studies.

The authors declared no competing interests or financial benefits. The article is listed as supported by NIH extramural and non-U.S. government sources.

Do not conclude that botulinum toxin or selective dorsal rhizotomy caused the observed muscle differences. Each treatment group had only one participant, and the authors state these differences should not be inferred as between-group effects.