Article

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.

Langue : ANGLAIS