Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

A Swedish Population-Based Study Found That Muscle Hypertonia in Children With Cerebral Palsy Varied by Age, Subtype, Functional Level, and Muscle Group

Hägglund, Gunnar LU and Alriksson-Schmidt, Ann I. LU (2026) In Acta Paediatrica, International Journal of Paediatrics 115(10). p.2261-2268
Abstract

Aim: We examined how lower limb muscle tone was related to age, sex, Gross Motor Function Classification System (GMFCS) level, and the cerebral palsy (CP) subtype in Swedish children with CP. Methods: This registry-based cohort study from 2023 to 2024 used data on all 3 216 children aged 1–15 from the Swedish follow-up program and national CP Registry. Muscle tone was assessed with the Ashworth Scale in the gastrocsoleus, hamstring, and adductor muscles. Associations between muscle tone and age, GMFCS level, sex, and CP subtype were analysed using descriptive statistics and logistic regression. Results: Hypertonia, defined as Ashworth grade ≥ 1, was present in the gastrocsoleus in 84% of the children, in the hamstrings in 52%, and in... (More)

Aim: We examined how lower limb muscle tone was related to age, sex, Gross Motor Function Classification System (GMFCS) level, and the cerebral palsy (CP) subtype in Swedish children with CP. Methods: This registry-based cohort study from 2023 to 2024 used data on all 3 216 children aged 1–15 from the Swedish follow-up program and national CP Registry. Muscle tone was assessed with the Ashworth Scale in the gastrocsoleus, hamstring, and adductor muscles. Associations between muscle tone and age, GMFCS level, sex, and CP subtype were analysed using descriptive statistics and logistic regression. Results: Hypertonia, defined as Ashworth grade ≥ 1, was present in the gastrocsoleus in 84% of the children, in the hamstrings in 52%, and in the adductors in 34%. Prevalence increased with higher GMFCS levels and varied across age and muscle groups. Gastrocsoleus hypertonia peaked at 7–9 years and then declined. Hamstring hypertonia increased steadily up to 13–15 years. Adductor hypertonia showed a U-shaped pattern across age groups. Children with bilateral spastic or dyskinetic CP had the highest hypertonia levels in all muscle groups. Conclusion: Muscle hypertonia in children with CP varied by age, GMFCS level, CP subtype, and muscle group. This should be considered when planning treatment strategies.

(Less)
Please use this url to cite or link to this publication:
author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ashworth scale, cerebral palsy, muscle tone, registry study, spasticity
in
Acta Paediatrica, International Journal of Paediatrics
volume
115
issue
10
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:105041485461
  • pmid:42287227
ISSN
0803-5253
DOI
10.1111/apa.70649
language
English
LU publication?
yes
id
dfc9e3eb-bf7c-4775-86ab-93a16ef87073
date added to LUP
2026-09-16 11:49:12
date last changed
2026-09-17 03:00:07
@article{dfc9e3eb-bf7c-4775-86ab-93a16ef87073,
  abstract     = {{<p>Aim: We examined how lower limb muscle tone was related to age, sex, Gross Motor Function Classification System (GMFCS) level, and the cerebral palsy (CP) subtype in Swedish children with CP. Methods: This registry-based cohort study from 2023 to 2024 used data on all 3 216 children aged 1–15 from the Swedish follow-up program and national CP Registry. Muscle tone was assessed with the Ashworth Scale in the gastrocsoleus, hamstring, and adductor muscles. Associations between muscle tone and age, GMFCS level, sex, and CP subtype were analysed using descriptive statistics and logistic regression. Results: Hypertonia, defined as Ashworth grade ≥ 1, was present in the gastrocsoleus in 84% of the children, in the hamstrings in 52%, and in the adductors in 34%. Prevalence increased with higher GMFCS levels and varied across age and muscle groups. Gastrocsoleus hypertonia peaked at 7–9 years and then declined. Hamstring hypertonia increased steadily up to 13–15 years. Adductor hypertonia showed a U-shaped pattern across age groups. Children with bilateral spastic or dyskinetic CP had the highest hypertonia levels in all muscle groups. Conclusion: Muscle hypertonia in children with CP varied by age, GMFCS level, CP subtype, and muscle group. This should be considered when planning treatment strategies.</p>}},
  author       = {{Hägglund, Gunnar and Alriksson-Schmidt, Ann I.}},
  issn         = {{0803-5253}},
  keywords     = {{Ashworth scale; cerebral palsy; muscle tone; registry study; spasticity}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{2261--2268}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Paediatrica, International Journal of Paediatrics}},
  title        = {{A Swedish Population-Based Study Found That Muscle Hypertonia in Children With Cerebral Palsy Varied by Age, Subtype, Functional Level, and Muscle Group}},
  url          = {{http://dx.doi.org/10.1111/apa.70649}},
  doi          = {{10.1111/apa.70649}},
  volume       = {{115}},
  year         = {{2026}},
}