{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T15:17:34Z","timestamp":1771859854050,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Background: Developing an evidence base for physiotherapy programs for patients with Cerebral Palsy (CP) requires an understanding of the microscopic and metabolic processes in striated muscle. The gracilis muscle represents a logical object of study due to the significant morphological changes in individuals with cerebral palsy. This research aims to study morphological and biochemical alterations in the gracilis muscle depending on the severity of motor impairments in CP patients. Methods: The cross-sectional study included 24 patients stratified by the severity of motor impairment. Intraoperative gracilis muscle samples were obtained during tenomyotomies. Nutritional status of patients, morphometric, and biochemical parameters were evaluated. Results: Initial body mass and Quetelet index (p = 0.02) were lower in GMFCS V patients (p = 0.01) compared to GMFCS IV and GMFCS II-III. Muscle tissue predominated in histological samples of GMFCS II-III and GMFCS V patients (p = 0.79), while connective tissue content was higher in the GMFCS IV group (p = 0.03). Strong, fast-twitch, anaerobic fibers (p = 0.761) with reduced creatine phosphokinase activity (p = 0.012) were more frequently observed in the intraoperative samples of GMFCS V patients. Low creatine phosphokinase activity was revealed in children in the GMFCS V group (p = 0.012). Conclusions: The structural and metabolic abnormalities observed in gracilis muscle of patients with spastic cerebral palsy indicates profound functional muscular dysfunction, representing one of the factors limiting children\u2019s motor ability. The morphological and biochemical alterations in the striated muscle of CP children correlate with severity of motor dysfunction conditioned by the primary upper motor neuron disorders. Less significant changes in muscles in ambulatory children reflect favorable basis for physical therapy.<\/jats:p>","DOI":"10.3390\/jfmk11010090","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T14:05:11Z","timestamp":1771855511000},"page":"90","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Morphological and Biochemical Abnormalities of Gracilis Muscle from Children with Cerebral Palsy"],"prefix":"10.3390","volume":"11","author":[{"given":"Vadim","family":"Evreinov","sequence":"first","affiliation":[{"name":"National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan 640014, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maksim","family":"Stogov","sequence":"additional","affiliation":[{"name":"National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan 640014, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Kireeva","sequence":"additional","affiliation":[{"name":"National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan 640014, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galina","family":"Filimonova","sequence":"additional","affiliation":[{"name":"National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan 640014, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatyana","family":"Zhirova","sequence":"additional","affiliation":[{"name":"Ural Chaklin Institute of Traumatology and Orthopedics, Ekaterinburg 620000, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3340-0766","authenticated-orcid":false,"given":"Margarita Alisa","family":"Popkova","sequence":"additional","affiliation":[{"name":"Biological Chemistry, Johannes Kepler University of Linz, 4040 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8996-867X","authenticated-orcid":false,"given":"Dmitry","family":"Popkov","sequence":"additional","affiliation":[{"name":"National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan 640014, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1152\/physiol.00054.2018","article-title":"A Critical Evaluation of Current Concepts in Cerebral Palsy","volume":"34","author":"Brandenburg","year":"2019","journal-title":"Physiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2622310","DOI":"10.1155\/2022\/2622310","article-title":"A Review on Recent Advances of Cerebral Palsy","volume":"2022","author":"Paul","year":"2022","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.pediatrneurol.2019.07.006","article-title":"Early Clinical Features of Cerebral Palsy in Children Without Perinatal Risk Factors: A Scoping Review","volume":"102","author":"Garfinkle","year":"2020","journal-title":"Pediatr. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1002\/jcsm.12287","article-title":"Determinants of muscle preservation in individuals with cerebral palsy across the lifespan: A narrative review of the literature","volume":"9","author":"Verschuren","year":"2018","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1111\/j.1469-8749.2010.03686.x","article-title":"Gross muscle morphology and structure in spastic cerebral palsy: A systematic review","volume":"52","author":"Barrett","year":"2010","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/dmcn.15018","article-title":"Understanding skeletal muscle in cerebral palsy: A path to personalized medicine?","volume":"64","author":"Howard","year":"2022","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Howard, J.J., and Herzog, W. (2021). Skeletal Muscle in Cerebral Palsy: From Belly to Myofibril. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.620852"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"von Walden, F., Fernandez-Gonzalo, R., Pingel, J., McCarthy, J., St\u00e5l, P., and Pont\u00e9n, E. (2020). Epigenetic Marks at the Ribosomal DNA Promoter in Skeletal Muscle Are Negatively Associated with Degree of Impairment in Cerebral Palsy. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00236"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1111\/dmcn.14964","article-title":"Reduced mitochondrial DNA and OXPHOS protein content in skeletal muscle of children with cerebral palsy","volume":"63","author":"Vechetti","year":"2021","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Handsfield, G.G., Williams, S., Khuu, S., Lichtwark, G., and Stott, N.S. (2022). Muscle architecture, growth, and biological remodelling in cerebral palsy: A narrative review. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05110-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.12965\/jer.1632552.276","article-title":"Metabolic, cardiorespiratory, and neuromuscular fitness performance in children with cerebral palsy: A comparison with healthy youth","volume":"12","author":"Ruiz","year":"2016","journal-title":"J. Exerc. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"475","DOI":"10.18019\/1028-4427-2021-27-4-475-480","article-title":"Multilevel orthopaedic surgery in children with spastic cerebral palsy","volume":"27","author":"Popkov","year":"2021","journal-title":"Genij Ortop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s13018-019-1239-1","article-title":"Relationship of muscle morphology to hip displacement in cerebral palsy: A pilot study investigating changes intrinsic to the sarcomere","volume":"14","author":"Howard","year":"2019","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/02692155211040199","article-title":"Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis","volume":"36","author":"Damiano","year":"2022","journal-title":"Clin. Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.ridd.2013.10.021","article-title":"Meta-analysis of the effect of strengthening interventions in individuals with cerebral palsy","volume":"35","author":"Park","year":"2014","journal-title":"Res. Dev. Disabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ridd.2014.09.024","article-title":"Efficacy of upper limb strengthening in children with Cerebral Palsy: A critical review","volume":"36","author":"Rameckers","year":"2015","journal-title":"Res. Dev. Disabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0004-9514(09)70037-6","article-title":"Muscle strengthening is not effective in children and adolescents with cerebral palsy: A systematic review","volume":"55","author":"Scianni","year":"2009","journal-title":"Aust. J. Physiother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1111\/dmcn.15055","article-title":"Interventions to improve physical function for children and young people with cerebral palsy: International clinical practice guideline","volume":"64","author":"Jackman","year":"2022","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3489","DOI":"10.1113\/JP285988","article-title":"Collagen architecture and biomechanics of gracilis and adductor longus muscles from children with cerebral palsy","volume":"602","author":"Wohlgemuth","year":"2024","journal-title":"J. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/dmcn.12027","article-title":"Reduced satellite cell population may lead to contractures in children with cerebral palsy","volume":"55","author":"Smith","year":"2013","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1002\/jor.22860","article-title":"Reduced satellite cell number in situ in muscular contractures from children with cerebral palsy","volume":"33","author":"Dayanidhi","year":"2015","journal-title":"J. Orthop. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano","year":"1997","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"223","DOI":"10.15690\/vsp.v17i3.1891","article-title":"Consistency in Assessing Physical Development of Children with Cerebral Palsy According to Regional and Specialized Centile Scales: A Population-Based Cross-Sectional Study","volume":"17","author":"Kovtun","year":"2018","journal-title":"Curr. Pediatr."},{"key":"ref_24","first-page":"19","article-title":"Cerebral palsy: Modern conception of classification systems","volume":"1","author":"Shalkevich","year":"2021","journal-title":"Meditsinskie Nov."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/jamapediatrics.2017.1689","article-title":"Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment","volume":"171","author":"Novak","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kostrominova, T.Y. (2022). Skeletal Muscle Denervation: Past, Present and Future. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23147489"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1113\/EP090576","article-title":"Muscle contraction force conforms to muscle oxygenation during constant-activation voluntary forearm exercise","volume":"107","author":"Drouin","year":"2022","journal-title":"Exp. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"C573","DOI":"10.1152\/ajpcell.00344.2023","article-title":"Histological analysis of the gastrocnemius muscle in preschool and school age children with cerebral palsy compared with age-matched typically developing children","volume":"326","author":"Deschrevel","year":"2024","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_29","first-page":"84","article-title":"Structural reorganization of reinnervated skeletal muscle during low-frequency electrical stimulation","volume":"4","author":"Shchudlo","year":"2010","journal-title":"Genij Ortop."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.21037\/tp.2020.01.01","article-title":"Cerebral palsy in children: A clinical overview","volume":"9","author":"Patel","year":"2020","journal-title":"Transl. Pediatr."},{"key":"ref_31","first-page":"e49050","article-title":"Cerebral Palsy: A Narrative Review on Childhood Disorder","volume":"15","author":"Basoya","year":"2023","journal-title":"Cureus"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1542\/hpeds.2020-0177","article-title":"The Impact of Malnutrition on Hospitalized Children with Cerebral Palsy","volume":"10","author":"Foster","year":"2020","journal-title":"Hosp. Pediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5047","DOI":"10.1007\/s00431-023-05177-9","article-title":"Low skeletal muscle mass and liver fibrosis in children with cerebral palsy","volume":"182","author":"Naume","year":"2023","journal-title":"Eur. J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bonilla, D.A., Kreider, R.B., Stout, J.R., Forero, D.A., Kerksick, C.M., Roberts, M.D., and Rawson, E.S. (2021). Metabolic Basis of Creatine in Health and Disease: A Bioinformatics-Assisted Review. Nutrients, 13.","DOI":"10.3390\/nu13041238"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/1\/90\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T14:27:50Z","timestamp":1771856870000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/1\/90"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,22]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jfmk11010090"],"URL":"https:\/\/doi.org\/10.3390\/jfmk11010090","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,22]]}}}