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. 2011 Dec;82(6):744-8.
doi: 10.3109/17453674.2011.618917. Epub 2011 Sep 6.

Spasticity of the gastrosoleus muscle is related to the development of reduced passive dorsiflexion of the ankle in children with cerebral palsy: a registry analysis of 2,796 examinations in 355 children

Gunnar Hägglund  1 , Philippe Wagner
Affiliations

Spasticity of the gastrosoleus muscle is related to the development of reduced passive dorsiflexion of the ankle in children with cerebral palsy: a registry analysis of 2,796 examinations in 355 children

Gunnar Hägglund et al. Acta Orthop. 2011 Dec.

Abstract

Background and purpose: Spasticity and muscle contracture are two common manifestations of cerebral palsy (CP). A spastic muscle may inhibit growth in length of the muscle, but the importance of this relationship is not known. In 1994, a register and a healthcare program for children with CP in southern Sweden were initiated. The child's muscle tone according to the Ashworth scale and the ankle range of motion (ROM) is measured annually during the entire growth period. We have used these data to analyze the relationship between spasticity and ROM of the gastrosoleus muscle.

Patients and methods: All measurements in the total population of children with CP aged 0-18 years during the period January 1995 through June 2008 were analyzed. The study was based on 2,796 examinations in 355 children. In the statistical analysis, the effect of muscle tone on ROM was estimated using a random effects model.

Results: The range of dorsiflexion of the ankle joint decreased in the total material by mean 19 (95% CI: 14-24) degrees during the first 18 years of life. There was a statistically significant association between the ROM and the child's level of spasticity during the year preceding the ROM measurement.

Interpretation: Spasticity is related to the development of muscle contracture. In the treatment of children with CP, the spasticity, contracture, and strength of the gastrosoleus muscle must be considered together.

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Figures

Figure 1.
Figure 1.
Development of dorsiflexion of the ankle joint (mean, 95% CI) up to 18 years of age in the total sample of 355 children with CP. The analysis is based on 2,796 examinations of both legs in all 355 children.
Figure 2.
Figure 2.
Development of dorsiflexion of the ankle joint (mean, 95% CI) related to level of spasticity according to the Ashworth scale.
See this image and copyright information in PMC

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