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. 2009 Oct 28:7:65.
doi: 10.1186/1741-7015-7-65.

Development of lower limb range of motion from early childhood to adolescence in cerebral palsy: a population-based study

Eva Nordmark  1 , Gunnar Hägglund, Henrik Lauge-Pedersen, Philippe Wagner, Lena Westbom
Affiliations

Development of lower limb range of motion from early childhood to adolescence in cerebral palsy: a population-based study

Eva Nordmark et al. BMC Med. .

Erratum in

  • BMC Med. 2010;8:49

Abstract

Background: The decreasing range of joint motion caused by insufficient muscle length is a common problem in children with cerebral palsy (CP), often worsening with age. In 1994 a CP register and health care programme for children with CP was initiated in southern Sweden. The aim of this study was to analyse the development of the passive range of motion (ROM) in the lower limbs during all the growth periods in relation to gross motor function and CP subtype in the total population of children with CP.

Methods: In total, 359 children with CP born during 1990-1999, living in the southernmost part of Sweden in the year during which they reached their third birthday and still living in the area in the year of their seventh birthday were analysed. The programme includes a continuous standardized follow-up with goniometric measurements of ROM in the lower limbs. The assessments are made by each child's local physiotherapist twice a year until 6 years of age, then once a year. In total, 5075 assessments from the CPUP database from 1994 to 1 January 2007 were analysed.

Results: The study showed a decreasing mean range of motion over the period 2-14 years of age in all joints or muscles measured. The development of ROM varied according to GMFCS level and CP subtype.

Conclusion: We found a decreasing ROM in children with CP from 2-14 years of age. This information is important for both the treatment and follow-up planning of the individual child as well as for the planning of health care programmes for all children with CP.

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Figures

Figure 1
Figure 1
Hip - abduction, mean range of motion (with 95% confidence interval) related to age at measurement in a total population of children with cerebral palsy.
Figure 2
Figure 2
Hip - external rotation, mean range of motion (with 95% confidence interval) related to age at measurement in a total population of children with cerebral palsy.
Figure 3
Figure 3
Popliteal angle, mean range of motion (with 95% confidence interval) related to age at measurement in a total population of children with cerebral palsy.
Figure 4
Figure 4
Knee - extension, mean range of motion (with 95% confidence interval) related to age at measurement in a total population of children with cerebral palsy.
Figure 5
Figure 5
Foot - dorsiflexion, mean range of motion (with 95% confidence interval) related to age at measurement in a total population of children with cerebral palsy.
Figure 6
Figure 6
Hip - abduction, mean range of motion (with 95% confidence interval) related to age at measurement and gross motor function classification system level in a total population of children with cerebral palsy.
Figure 7
Figure 7
Hip - external rotation, mean range of motion (with 95% confidence interval) related to age at measurement and gross motor function classification system level in a total population of children with cerebral palsy.
Figure 8
Figure 8
Popliteal angle, mean range of motion (with 95% confidence interval) related to age at measurement and gross motor function classification system level in a total population of children with cerebral palsy.
Figure 9
Figure 9
Knee - extension, mean range of motion (with 95% confidence interval) related to age at measurement and gross motor function classification system level in a total population of children with cerebral palsy.
Figure 10
Figure 10
Foot - dorsiflexion, mean range of motion (with 95% confidence interval) related to age at measurement and gross motor function classification system level in a total population of children with cerebral palsy.
Figure 11
Figure 11
Hip - abduction, mean range of motion (with 95% confidence interval) related to age at measurement and cerebral palsy (CP) subtype in a total population of children with CP.
Figure 12
Figure 12
Hip - external rotation, mean range of motion (with 95% confidence interval) related to age at measurement and cerebral palsy (CP) subtype in a total population of children with CP.
Figure 13
Figure 13
Popliteal angle, mean range of motion (with 95% confidence interval) related to age at measurement and cerebral palsy (CP) subtype in a total population of children with CP.
Figure 14
Figure 14
Knee - extension, mean range of motion (with 95% confidence interval) related to age at measurement and cerebral palsy (CP) subtype in a total population of children with CP.
Figure 15
Figure 15
Foot - dorsiflexion, mean range of motion (with 95% confidence interval) related to age at measurement and cerebral palsy (CP) subtype in a total population of children with CP.
See this image and copyright information in PMC

References

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