Ankle contractures are frequent among children with cerebral palsy and associated with lower gross motor function and degree of spasticity

TY - JOUR

T1 - Ankle contractures are frequent among children with cerebral palsy and associated with lower gross motor function and degree of spasticity

AU - Krarup, Laerke Hartvig

AU - Kristensen, Pia Kjaer

AU - Strand, Louise

AU - Bredtoft, Sofie Langbo

AU - Mechlenburg, Inger

AU - Nordbye-Nielsen, Kirsten

N1 - This article is protected by copyright. All rights reserved.

PY - 2021/7

Y1 - 2021/7

N2 - AIM: To estimate yearly prevalence of ankle contractures among children with cerebral palsy (CP). Moreover, to investigate if age, gross motor function or spasticity are associated with ankle contracture.METHODS: We examined yearly prevalence of ankle contractures among 933 children based on data from a national clinical quality database from 2012 to 2019. We used the Gross Motor Function Classification System (GMFCS) and the Modified Ashworth Scale (MAS) to assess gross motor function and spasticity in the plantar flexors. Ankle contracture was defined as dorsiflexion with an extended knee equal to or below 0 degrees. Associations between age, GMFCS, spasticity and ankle contractures were analyzed using multivariable regression and presented as odds ratios (OR) with 95% confidence intervals (95%CI).RESULTS: The prevalence of ankle contracture was 32% and did not change with calendar year. GMFCS IV-V compared to I-III (40.6% vs. 28.9%, OR = 1.5 (95%CI: 1.07-2.11) and MAS 2-4 compared to 0 (44.6% vs. 24.4%, OR = 2.5 (95%CI: 1.59-3.91) were associated with a higher prevalence of ankle contracture. Age was not associated with ankle contracture.CONCLUSION: Ankle contractures are frequent among children with CP. Lower gross motor function and severe spasticity were associated with ankle contracture.

AB - AIM: To estimate yearly prevalence of ankle contractures among children with cerebral palsy (CP). Moreover, to investigate if age, gross motor function or spasticity are associated with ankle contracture.METHODS: We examined yearly prevalence of ankle contractures among 933 children based on data from a national clinical quality database from 2012 to 2019. We used the Gross Motor Function Classification System (GMFCS) and the Modified Ashworth Scale (MAS) to assess gross motor function and spasticity in the plantar flexors. Ankle contracture was defined as dorsiflexion with an extended knee equal to or below 0 degrees. Associations between age, GMFCS, spasticity and ankle contractures were analyzed using multivariable regression and presented as odds ratios (OR) with 95% confidence intervals (95%CI).RESULTS: The prevalence of ankle contracture was 32% and did not change with calendar year. GMFCS IV-V compared to I-III (40.6% vs. 28.9%, OR = 1.5 (95%CI: 1.07-2.11) and MAS 2-4 compared to 0 (44.6% vs. 24.4%, OR = 2.5 (95%CI: 1.59-3.91) were associated with a higher prevalence of ankle contracture. Age was not associated with ankle contracture.CONCLUSION: Ankle contractures are frequent among children with CP. Lower gross motor function and severe spasticity were associated with ankle contracture.

KW - ankle contracture

KW - cerebral palsy

KW - children

KW - gross motor function

KW - muscle spasticity

U2 - 10.1111/apa.15804

DO - 10.1111/apa.15804

M3 - Journal article

C2 - 33565134

SN - 0803-5253

VL - 110

SP - 2171

EP - 2178

JO - Acta paediatrica (Oslo, Norway : 1992)

JF - Acta paediatrica (Oslo, Norway : 1992)

IS - 7

ER -