Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Upper-limb range of motion in children with cerebral palsy treated with botulinum neurotoxin : a population-based cohort study

Hedberg-Graff, Jenny ; Granström, Fredrik ; Arner, Marianne ; Rodby-Bousquet, Elisabet LU orcid and Krumlinde-Sundholm, Lena (2026) In BMC Musculoskeletal Disorders 27(1).
Abstract

Background: Our aim was to investigate change over time of passive range of motion (pROM) in the upper limbs of children with cerebral palsy (CP), treated or not treated with botulinum neurotoxin-A (BoNT-A). Methods: Data from 2000 to 2017 were collected from the Cerebral Palsy follow-up program and registry in Sweden (CPUP) for children with spastic or dyskinetic CP. Mixed models were used to analyse changes in pROM from the first, until the last measurement for five upper limb movements. Results: The study involved 496 children with CP, aged 1–15 years (median 2 years, Interquartile range = 4). Of these, 22% had received at least one BoNT-A treatment. Contractures were classified as red (severe) or yellow (moderate) based on the... (More)

Background: Our aim was to investigate change over time of passive range of motion (pROM) in the upper limbs of children with cerebral palsy (CP), treated or not treated with botulinum neurotoxin-A (BoNT-A). Methods: Data from 2000 to 2017 were collected from the Cerebral Palsy follow-up program and registry in Sweden (CPUP) for children with spastic or dyskinetic CP. Mixed models were used to analyse changes in pROM from the first, until the last measurement for five upper limb movements. Results: The study involved 496 children with CP, aged 1–15 years (median 2 years, Interquartile range = 4). Of these, 22% had received at least one BoNT-A treatment. Contractures were classified as red (severe) or yellow (moderate) based on the Traffic Light system within CPUP. About 36% developed upper limb contractures before age 15. Early BoNT-A treatment (< 4 years) implied better pROM outcomes over time compared with later treatment, after adjusting for pROM category, CP subtype and level of manual ability. Conclusions: Upper limb contractures can develop during growth in children with CP affecting one third of this population. Early monitoring of pROM can detect the first signs of muscle shortening before contractures are established. Our findings suggest that early BoNT-A treatment may help maintain pROM in children with CP.

(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
Botulinum neurotoxin a, Cerebral palsy, Children, Range of motion, Upper limb
in
BMC Musculoskeletal Disorders
volume
27
issue
1
article number
65
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41588536
  • scopus:105028768770
ISSN
1471-2474
DOI
10.1186/s12891-026-09528-z
language
English
LU publication?
yes
id
ff5965c8-e34e-465c-b787-a6bbb6436acd
date added to LUP
2026-02-17 12:26:04
date last changed
2026-02-18 03:00:10
@article{ff5965c8-e34e-465c-b787-a6bbb6436acd,
  abstract     = {{<p>Background: Our aim was to investigate change over time of passive range of motion (pROM) in the upper limbs of children with cerebral palsy (CP), treated or not treated with botulinum neurotoxin-A (BoNT-A). Methods: Data from 2000 to 2017 were collected from the Cerebral Palsy follow-up program and registry in Sweden (CPUP) for children with spastic or dyskinetic CP. Mixed models were used to analyse changes in pROM from the first, until the last measurement for five upper limb movements. Results: The study involved 496 children with CP, aged 1–15 years (median 2 years, Interquartile range = 4). Of these, 22% had received at least one BoNT-A treatment. Contractures were classified as red (severe) or yellow (moderate) based on the Traffic Light system within CPUP. About 36% developed upper limb contractures before age 15. Early BoNT-A treatment (&lt; 4 years) implied better pROM outcomes over time compared with later treatment, after adjusting for pROM category, CP subtype and level of manual ability. Conclusions: Upper limb contractures can develop during growth in children with CP affecting one third of this population. Early monitoring of pROM can detect the first signs of muscle shortening before contractures are established. Our findings suggest that early BoNT-A treatment may help maintain pROM in children with CP.</p>}},
  author       = {{Hedberg-Graff, Jenny and Granström, Fredrik and Arner, Marianne and Rodby-Bousquet, Elisabet and Krumlinde-Sundholm, Lena}},
  issn         = {{1471-2474}},
  keywords     = {{Botulinum neurotoxin a; Cerebral palsy; Children; Range of motion; Upper limb}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{Upper-limb range of motion in children with cerebral palsy treated with botulinum neurotoxin : a population-based cohort study}},
  url          = {{http://dx.doi.org/10.1186/s12891-026-09528-z}},
  doi          = {{10.1186/s12891-026-09528-z}},
  volume       = {{27}},
  year         = {{2026}},
}