AI Article Synopsis
- The study aimed to analyze the development of passive range of motion (ROM) in the upper limbs of children with cerebral palsy (CP) and identify factors that contribute to the likelihood of developing contractures.
- Data from 771 children with CP showed that 34% developed contractures, with significant decreases in passive ROM observed starting at an average age of 4 for wrist extension and 7 for shoulder flexion and elbow movement.
- The strongest predictor for developing contractures was the child's level on the Manual Ability Classification System (MACS), with those at MACS level V being 17 times more likely to develop contractures than those at level I.
Article Abstract
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.
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| http://dx.doi.org/10.1111/dmcn.14006 | DOI Listing |
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