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The development of spasticity with age in 4,162 children with cerebral palsy: a register-based prospective cohort study
Lund Univ, Dept Clin Sci, Orthoped, Lund, Sweden.
Lund Univ, Dept Clin Sci, Orthoped, Lund, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Lund Univ, Dept Clin Sci, Orthoped, Lund, Sweden.ORCID iD: 0000-0001-8373-1017
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
2019 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 90, no 3, p. 286-291Article in journal (Refereed) Published
Abstract [en]

Background and purpose

Spasticity is often regarded as a major cause of functional limitation in children with cerebral palsy (CP). We analyzed the spasticity development with age in the gastrosoleus muscle in children with CP.

Children and methods

This is a longitudinal cohort study of 4,162 children (57% boys) with CP born in 1990-2015, monitored using standardized follow-up examinations in the Swedish surveillance program for CP. The study is based on 57,953 measurements of spasticity of the gastrosoleus muscle assessed using the Ashworth scale (AS) in participants between 0 and 15 years of age. The spasticity was analyzed in relation to age, sex, and Gross Motor Function Classification System (GMFCS) levels using a linear mixed model. Development of spasticity with age was modeled as a linear spline.

Results

The degree of spasticity increased in most children over the first 5 years of life. At 5 years of age, 38% had an AS level of 2. The spasticity then decreased for 65% of the children during the remaining study period. At 15 years of age only 22% had AS 2. The level of spasticity and the rate of increase and decrease before and after 5.5 years of age were higher in children at GMFCS IV-V.

Interpretation

The degree of spasticity of the gastrosoleus muscle often decreases after 5 years of age, which is important for long-term treatment planning and should be considered in spasticity management.

Place, publisher, year, edition, pages
2019. Vol. 90, no 3, p. 286-291
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:uu:diva-387597DOI: 10.1080/17453674.2019.1590769ISI: 000469038600018PubMedID: 30907682OAI: oai:DiVA.org:uu-387597DiVA, id: diva2:1331266
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-06-26Bibliographically approved

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Rodby-Bousquet, ElisabetWagner, Philippe
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