Pathomorphological Changes in the Gracilis Muscle in Patients with Spastic Forms of Cerebral Palsy

Introduction . The cause of muscle contractures in patients with cerebral palsy is not fully understood. The aim of the study was to study the pathomorphological changes in the gracilis muscle (musculus gracilis) to determine the most effective strategy for treating contractures depending on the level of movement disorders in patients with cerebral palsy. Materials and methods . Patients ( n = 24) were divided into three groups according to the Gross Motor Function Classification System (GMFCS) scale. Histological examination of m. gracilis was performed, morphometric parameters were assessed. Results . Myopathy of varying severity was detected in patients. In GMFCS II–III, an inverse statistical relationship was found between the percentage of muscle tissue in micropreparations and the Quetelet body mass index. In children of GMFCS IV and V, a negative correlation was recorded between the proportions of contractile and connective tissue in histological sections. Discussion . Changes in m. gracilis are due to spastic syndrome. Interventions on the tendon-muscle apparatus do not affect the functional abilities of children with cerebral palsy. Conclusions . The pathomorphological picture of the sections of m. gracilis corresponds to myopathy, the severity of which depends on the severity of motor limitations of children with cerebral palsy. Shortening of sarcomeres in myofibrils of m. gracilis is one of the reasons for the formation of adduction contractures of the hip joints in patients with cerebral palsy. Therapeutic and surgical interventions on the tendon-muscle system do not increase the muscle strength of children with cerebral palsy and do not affect their functional abilities.