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Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children
Background and purpose — Joint contracture is a common problem among children with cerebral palsy (CP). To prevent severe contracture and its effects on adjacent joints, it is crucial to identify children with a reduced range of motion (ROM) early. We examined whether significant hip, knee, or foot...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Taylor & Francis
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158222/ https://www.ncbi.nlm.nih.gov/pubmed/33228441 http://dx.doi.org/10.1080/17453674.2020.1848154 |
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author | Cloodt, Erika Wagner, Philippe Lauge-Pedersen, Henrik Rodby-Bousquet, Elisabet |
author_facet | Cloodt, Erika Wagner, Philippe Lauge-Pedersen, Henrik Rodby-Bousquet, Elisabet |
author_sort | Cloodt, Erika |
collection | PubMed |
description | Background and purpose — Joint contracture is a common problem among children with cerebral palsy (CP). To prevent severe contracture and its effects on adjacent joints, it is crucial to identify children with a reduced range of motion (ROM) early. We examined whether significant hip, knee, or foot contracture occurs earliest in children with CP. Patients and methods — This was a longitudinal study involving 27,230 measurements obtained for 2,693 children (59% boys, 41% girls) with CP born 1990 to 2018 and registered before 5 years of age in the Swedish surveillance program for CP. The analysis was based on 4,751 legs followed up for an average of 5.0 years. Separate Kaplan–Meier (KM) curves were drawn for each ROM to illustrate the proportions of contracture-free legs at a given time during the follow-up. Using a clustered bootstrap method and considering the child as the unit of clustering, 95% pointwise confidence intervals were generated for equally spaced time points every 2.5 years for each KM curve. Results — Contracture developed in 34% of all legs, and the median time to the first contracture was 10 years from the first examination. Contracture was most common in children with a higher Gross Motor Function Classification System (GMFCS) level. The first contracture was a flexion contracture preventing dorsiflexion in children with GMFCS level I or II and preventing knee extension in children with GMFCS level III to V. Interpretation — Early interventions to prevent knee and foot contractures in children with CP should be considered. |
format | Online Article Text |
id | pubmed-8158222 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-81582222021-06-07 Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children Cloodt, Erika Wagner, Philippe Lauge-Pedersen, Henrik Rodby-Bousquet, Elisabet Acta Orthop Research Article Background and purpose — Joint contracture is a common problem among children with cerebral palsy (CP). To prevent severe contracture and its effects on adjacent joints, it is crucial to identify children with a reduced range of motion (ROM) early. We examined whether significant hip, knee, or foot contracture occurs earliest in children with CP. Patients and methods — This was a longitudinal study involving 27,230 measurements obtained for 2,693 children (59% boys, 41% girls) with CP born 1990 to 2018 and registered before 5 years of age in the Swedish surveillance program for CP. The analysis was based on 4,751 legs followed up for an average of 5.0 years. Separate Kaplan–Meier (KM) curves were drawn for each ROM to illustrate the proportions of contracture-free legs at a given time during the follow-up. Using a clustered bootstrap method and considering the child as the unit of clustering, 95% pointwise confidence intervals were generated for equally spaced time points every 2.5 years for each KM curve. Results — Contracture developed in 34% of all legs, and the median time to the first contracture was 10 years from the first examination. Contracture was most common in children with a higher Gross Motor Function Classification System (GMFCS) level. The first contracture was a flexion contracture preventing dorsiflexion in children with GMFCS level I or II and preventing knee extension in children with GMFCS level III to V. Interpretation — Early interventions to prevent knee and foot contractures in children with CP should be considered. Taylor & Francis 2020-11-24 /pmc/articles/PMC8158222/ /pubmed/33228441 http://dx.doi.org/10.1080/17453674.2020.1848154 Text en © 2020 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Cloodt, Erika Wagner, Philippe Lauge-Pedersen, Henrik Rodby-Bousquet, Elisabet Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
title | Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
title_full | Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
title_fullStr | Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
title_full_unstemmed | Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
title_short | Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
title_sort | knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158222/ https://www.ncbi.nlm.nih.gov/pubmed/33228441 http://dx.doi.org/10.1080/17453674.2020.1848154 |
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