The development of spasticity with age in 4,162 children with cerebral palsy: a register-based prospective cohort study.

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 ch...

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Publicado en:Acta Orthopaedica Vol. 90; no. 3; pp. 286 - 292
Autores principales: Lindén, Olof, Hägglund, Gunnar, Rodby-Bousquet, Elisabet, Wagner, Philippe
Formato: research tables/charts Journal Article
Publicado: Medical Journals Sweden AB Jun2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2019
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      pub: Medical Journals Sweden AB
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        10.1080/17453674.2019.1590769
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        atl: The development of spasticity with age in 4,162 children with cerebral palsy: a register-based prospective cohort study.
      aug:
        au:
          Lindén, Olof
          Hägglund, Gunnar
          Rodby-Bousquet, Elisabet
          Wagner, Philippe
        affil: Department of Clinical Sciences, Lund, Orthopedics, Lund University, Sweden
      sug:
        subj:
          Muscle Spasticity Risk Factors
          Cerebral Palsy Complications
          Gastrocnemius Muscle Pathology
          Age Factors
          Human
          Prospective Studies
          Registries, Disease
          Sweden
          Disease Surveillance
          Program Evaluation
          Scales
          Infant, Newborn
          Infant
          Child, Preschool
          Child
          Adolescence
          Sex Factors
          Data Analysis, Statistical Methods
          Male
          Female
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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