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Upper-limb contracture development in children with cerebral palsy: a population-based study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).ORCID iD: 0000-0002-6174-3874
Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden; Södersjukhuset, Dept Hand Surg, Stockholm, Sweden.
Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
2019 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 61, no 2, p. 204-+Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to investigate the longitudinal development of passive range of motion (ROM) in the upper limbs in a population‐based sample of children with cerebral palsy (CP), and to investigate which children are more likely to develop contractures related to functional level, CP subtype, and age.

Method: Registry data of annual passive ROM measurements of the upper limbs from 771 children with CP (417 males, 354 females; mean age 11y 8mo, [SD 5mo] range 1–18y) were analysed. Mixed models were used to investigate at what age decreased passive ROM occurs. Odds ratios were calculated to compare risks and logistic regression analysis was used to predict contracture development.

Results: Thirty‐four per cent of the children had developed contractures. Among these children, decreased passive ROM was significant at a mean age of 4 years for wrist extension and 7 years for shoulder flexion, elbow extension, and supination. Children at Manual Ability Classification System (MACS) level V had a 17‐times greater risk of contractures than children at MACS level I.

Interpretation: One‐third of the children in the total population developed upper‐limb contractures while passive ROM decreased with age. MACS level was the strongest predictor of contracture development.

What this paper adds:

  • In a population‐based sample of 771 children with cerebral palsy, 34% developed an upper‐limb contracture.
  • Contracture development started at preschool age.
  • The first affected movements were wrist extension and supination.
  • Passive range of motion decreased with age.
  • High Manual Ability Classification System level was the most important predictor of contractures.
Place, publisher, year, edition, pages
2019. Vol. 61, no 2, p. 204-+
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:uu:diva-360623DOI: 10.1111/dmcn.14006ISI: 000456180800024PubMedID: 30203516OAI: oai:DiVA.org:uu-360623DiVA, id: diva2:1248595
Available from: 2018-09-17 Created: 2018-09-17 Last updated: 2019-02-12Bibliographically approved

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Granström, Fredrik

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