{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:14:39Z","timestamp":1782216879292,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,3,8]],"date-time":"2020-03-08T00:00:00Z","timestamp":1583625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["H133E100007"],"award-info":[{"award-number":["H133E100007"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["90DP0099"],"award-info":[{"award-number":["90DP0099"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["90BISB0001"],"award-info":[{"award-number":["90BISB0001"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the neural and non\u2010neural contributions to spasticity in the impaired ankle of children with cerebral palsy (CP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Instrumented tapping of the Achilles tendon was done isometrically to minimize non\u2010neural contributions and elicit neural contributions. Robot\u2010controlled ankle stretching was done at various velocities, including slow stretching, with minimized neural contributions. Spasticity was assessed as having neural (phasic and tonic stretch reflex torque, tendon reflex gain, contraction rate, and half relaxation rate) and non\u2010neural origin (elastic stiffness and viscous damping) in 17 children with CP (six females and 11 males; mean age [SD] 10y 8mo [3y 11mo], range 4y\u201318y) and 17 typically developing children (six females and 11 males; mean age [SD] 12y 7mo [2y 9mo], range 7y\u201318y). All torques were normalized to weight\u00d7height.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Children with CP showed increased phasic and tonic stretch reflex torque (<jats:italic>p<\/jats:italic>=0.004 and <jats:italic>p<\/jats:italic>=0.001 respectively), tendon reflex gain (<jats:italic>p<\/jats:italic>=0.02), contraction rate (<jats:italic>p<\/jats:italic>=0.038), half relaxation rate (<jats:italic>p<\/jats:italic>=0.02), elastic stiffness (<jats:italic>p<\/jats:italic>=0.01), and viscous damping (<jats:italic>p<\/jats:italic>=0.01) compared to typically developing children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Controlled stretching and instrumented tendon tapping allow the systematic quantification of various neural and non\u2010neural changes in CP, which can be used to guide impairment\u2010specific treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Ankle spasticity is associated with increased phasic and tonic stretch reflexes, tendon reflex gain, and contraction and half relaxation rates.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Ankle spasticity is also associated with increased elastic stiffness and viscous damping.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14506","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T04:48:55Z","timestamp":1583729335000},"page":"1040-1046","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Neural and non\u2010neural contributions to ankle spasticity in children with cerebral palsy"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9638-0030","authenticated-orcid":false,"given":"Dali","family":"Xu","sequence":"first","affiliation":[{"name":"Physical Therapy and Rehabilitation Science University of Maryland Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8369-6717","authenticated-orcid":false,"given":"Yi\u2010Ning","family":"Wu","sequence":"additional","affiliation":[{"name":"Physical Therapy and Kinesiology University of Massachusetts Lowell Lowell MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Gaebler\u2010Spira","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Gao","sequence":"additional","affiliation":[{"name":"Kinesiology University of Kentucky Lexington KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy J","family":"Clegg","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1855-8654","authenticated-orcid":false,"given":"Mauricio R","family":"Delgado","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children Dallas TX USA"},{"name":"Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5882-7965","authenticated-orcid":false,"given":"Li\u2010Qun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Physical Therapy and Rehabilitation Science University of Maryland Baltimore MD USA"},{"name":"Orthopaedics University of Maryland Baltimore MD USA"},{"name":"Bioengineering University of Maryland College Park MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,8]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"485","volume-title":"Spasticity: disordered motor control","author":"Lance JW","year":"1980"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/00003086-198706000-00009","article-title":"Cerebral palsy. 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