Urine hydroxyproline correlates with progression of spasticity in cerebral palsy

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Abstract

Background: Most Cerebral Palsy (CP) patients develop muscle spasticity which is characterized by jerky movements and muscle and joint stiffness. This increase of muscle stiffness in spastic CP has been correlated with the accumulation of collagen in the muscle as detected by the increase in muscle hydroxyproline, a major component of collagen. Objective: The objective of the study is to determine if there is any correlation between muscle and urine hydroxyproline levels in spastic CP. Further, to determine if Urine Hydroxyproline levels are different between spastic CP with and without contracture. Finally to determine if UH levels can be correlated with severity of CP as determined by Modified Ashworth Scale (MAS) and Gross Motor Function Classification System (GMFCS) scores. Methods: This was a cross sectional comparative study, conducted in the tertiary hospital, Malaysia from June’2012 to December’2014. Children with spastic CP (6 to 18 years) who were scheduled for muscle/tendon lengthening as part of the on going management and children with pure spasticity were included in this study. Normal children who are aged and sex matched to the CP children were included. Muscle biopsy and urine samples were collected for MH and UH analysis respectively. Results: A total of 48 children, aged 6 to 18 years (17 normal; 16 spastic CP without contracture, 15 spastic CP with contracture) were included in this study. Muscle biopsy (only for CP children with contracture) and urine samples were collected. A significant negative correlation was noted between the MH (261.894±69.077ng/ml) and UH (13.266±7.999ng/ml) levels (p=0.031). There was a statistically significant correlation between UH levels and the MAS score (p=0.01), and GMFCS score (p=0.015). Conclusion: UH quantification may be an objective tool to estimate the severity and progression of spasticity in CP.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalElectronic Journal of General Medicine
Volume15
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Fingerprint

Hydroxyproline
Cerebral Palsy
Urine
Muscles
Contracture
Collagen
Tenotomy
Biopsy
Muscle Spasticity
Malaysia
Tertiary Care Centers
Cross-Sectional Studies
Joints

Keywords

  • Cerebral palsy
  • Collagen
  • Contracture
  • Hydroxyproline
  • Muscle spasticity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Urine hydroxyproline correlates with progression of spasticity in cerebral palsy",
abstract = "Background: Most Cerebral Palsy (CP) patients develop muscle spasticity which is characterized by jerky movements and muscle and joint stiffness. This increase of muscle stiffness in spastic CP has been correlated with the accumulation of collagen in the muscle as detected by the increase in muscle hydroxyproline, a major component of collagen. Objective: The objective of the study is to determine if there is any correlation between muscle and urine hydroxyproline levels in spastic CP. Further, to determine if Urine Hydroxyproline levels are different between spastic CP with and without contracture. Finally to determine if UH levels can be correlated with severity of CP as determined by Modified Ashworth Scale (MAS) and Gross Motor Function Classification System (GMFCS) scores. Methods: This was a cross sectional comparative study, conducted in the tertiary hospital, Malaysia from June’2012 to December’2014. Children with spastic CP (6 to 18 years) who were scheduled for muscle/tendon lengthening as part of the on going management and children with pure spasticity were included in this study. Normal children who are aged and sex matched to the CP children were included. Muscle biopsy and urine samples were collected for MH and UH analysis respectively. Results: A total of 48 children, aged 6 to 18 years (17 normal; 16 spastic CP without contracture, 15 spastic CP with contracture) were included in this study. Muscle biopsy (only for CP children with contracture) and urine samples were collected. A significant negative correlation was noted between the MH (261.894±69.077ng/ml) and UH (13.266±7.999ng/ml) levels (p=0.031). There was a statistically significant correlation between UH levels and the MAS score (p=0.01), and GMFCS score (p=0.015). Conclusion: UH quantification may be an objective tool to estimate the severity and progression of spasticity in CP.",
keywords = "Cerebral palsy, Collagen, Contracture, Hydroxyproline, Muscle spasticity",
author = "Ohnmar Htwe and Selvyn Lloyd and Ng, {Min Hwei} and Andrea Richard and {Abd Rashid}, {Abdul Halim} and {Selvi Naicker}, Amaramalar and Sharaf Ibrahim",
year = "2018",
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doi = "10.29333/ejgm/81726",
language = "English",
volume = "15",
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T1 - Urine hydroxyproline correlates with progression of spasticity in cerebral palsy

AU - Htwe, Ohnmar

AU - Lloyd, Selvyn

AU - Ng, Min Hwei

AU - Richard, Andrea

AU - Abd Rashid, Abdul Halim

AU - Selvi Naicker, Amaramalar

AU - Ibrahim, Sharaf

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Most Cerebral Palsy (CP) patients develop muscle spasticity which is characterized by jerky movements and muscle and joint stiffness. This increase of muscle stiffness in spastic CP has been correlated with the accumulation of collagen in the muscle as detected by the increase in muscle hydroxyproline, a major component of collagen. Objective: The objective of the study is to determine if there is any correlation between muscle and urine hydroxyproline levels in spastic CP. Further, to determine if Urine Hydroxyproline levels are different between spastic CP with and without contracture. Finally to determine if UH levels can be correlated with severity of CP as determined by Modified Ashworth Scale (MAS) and Gross Motor Function Classification System (GMFCS) scores. Methods: This was a cross sectional comparative study, conducted in the tertiary hospital, Malaysia from June’2012 to December’2014. Children with spastic CP (6 to 18 years) who were scheduled for muscle/tendon lengthening as part of the on going management and children with pure spasticity were included in this study. Normal children who are aged and sex matched to the CP children were included. Muscle biopsy and urine samples were collected for MH and UH analysis respectively. Results: A total of 48 children, aged 6 to 18 years (17 normal; 16 spastic CP without contracture, 15 spastic CP with contracture) were included in this study. Muscle biopsy (only for CP children with contracture) and urine samples were collected. A significant negative correlation was noted between the MH (261.894±69.077ng/ml) and UH (13.266±7.999ng/ml) levels (p=0.031). There was a statistically significant correlation between UH levels and the MAS score (p=0.01), and GMFCS score (p=0.015). Conclusion: UH quantification may be an objective tool to estimate the severity and progression of spasticity in CP.

AB - Background: Most Cerebral Palsy (CP) patients develop muscle spasticity which is characterized by jerky movements and muscle and joint stiffness. This increase of muscle stiffness in spastic CP has been correlated with the accumulation of collagen in the muscle as detected by the increase in muscle hydroxyproline, a major component of collagen. Objective: The objective of the study is to determine if there is any correlation between muscle and urine hydroxyproline levels in spastic CP. Further, to determine if Urine Hydroxyproline levels are different between spastic CP with and without contracture. Finally to determine if UH levels can be correlated with severity of CP as determined by Modified Ashworth Scale (MAS) and Gross Motor Function Classification System (GMFCS) scores. Methods: This was a cross sectional comparative study, conducted in the tertiary hospital, Malaysia from June’2012 to December’2014. Children with spastic CP (6 to 18 years) who were scheduled for muscle/tendon lengthening as part of the on going management and children with pure spasticity were included in this study. Normal children who are aged and sex matched to the CP children were included. Muscle biopsy and urine samples were collected for MH and UH analysis respectively. Results: A total of 48 children, aged 6 to 18 years (17 normal; 16 spastic CP without contracture, 15 spastic CP with contracture) were included in this study. Muscle biopsy (only for CP children with contracture) and urine samples were collected. A significant negative correlation was noted between the MH (261.894±69.077ng/ml) and UH (13.266±7.999ng/ml) levels (p=0.031). There was a statistically significant correlation between UH levels and the MAS score (p=0.01), and GMFCS score (p=0.015). Conclusion: UH quantification may be an objective tool to estimate the severity and progression of spasticity in CP.

KW - Cerebral palsy

KW - Collagen

KW - Contracture

KW - Hydroxyproline

KW - Muscle spasticity

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