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

Lindén, Olof LU ; Hägglund, Gunnar LU ; Rodby-Bousquet, Elisabet LU and Wagner, Philippe LU (2019) In Acta Orthopaedica 90(3). p.286-291
Abstract

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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
90
issue
3
pages
286 - 291
publisher
Taylor & Francis
external identifiers
  • scopus:85063452377
ISSN
1745-3674
DOI
10.1080/17453674.2019.1590769
language
English
LU publication?
yes
id
edd2c031-510c-47b7-8d67-a58972366fc7
date added to LUP
2019-04-08 14:26:49
date last changed
2019-10-15 07:01:35
@article{edd2c031-510c-47b7-8d67-a58972366fc7,
  abstract     = {<p>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.</p>},
  author       = {Lindén, Olof and Hägglund, Gunnar and Rodby-Bousquet, Elisabet and Wagner, Philippe},
  issn         = {1745-3674},
  language     = {eng},
  month        = {03},
  number       = {3},
  pages        = {286--291},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {The development of spasticity with age in 4,162 children with cerebral palsy : a register-based prospective cohort study},
  url          = {http://dx.doi.org/10.1080/17453674.2019.1590769},
  volume       = {90},
  year         = {2019},
}