Nordmark Eva, Hägglund Gunnar, Lauge-Pedersen Henrik, Wagner Philippe, Westbom Lena
Department of Health Sciences, Division of Physiotherapy, Lund University, SE-221 00 Lund, Sweden.
BMC Med. 2009 Oct 28;7:65. doi: 10.1186/1741-7015-7-65.
The decreasing range of joint motion caused by insufficient muscle length is a common problem in children with cerebral palsy (CP), often worsening with age. In 1994 a CP register and health care programme for children with CP was initiated in southern Sweden. The aim of this study was to analyse the development of the passive range of motion (ROM) in the lower limbs during all the growth periods in relation to gross motor function and CP subtype in the total population of children with CP.
In total, 359 children with CP born during 1990-1999, living in the southernmost part of Sweden in the year during which they reached their third birthday and still living in the area in the year of their seventh birthday were analysed. The programme includes a continuous standardized follow-up with goniometric measurements of ROM in the lower limbs. The assessments are made by each child's local physiotherapist twice a year until 6 years of age, then once a year. In total, 5075 assessments from the CPUP database from 1994 to 1 January 2007 were analysed.
The study showed a decreasing mean range of motion over the period 2-14 years of age in all joints or muscles measured. The development of ROM varied according to GMFCS level and CP subtype.
We found a decreasing ROM in children with CP from 2-14 years of age. This information is important for both the treatment and follow-up planning of the individual child as well as for the planning of health care programmes for all children with CP.
肌肉长度不足导致的关节活动范围减小是脑瘫（CP）儿童的常见问题，且常随年龄增长而恶化。1994年，瑞典南部启动了一项针对脑瘫儿童的登记册和医疗保健计划。本研究的目的是分析脑瘫儿童总体人群在所有生长阶段下肢被动活动范围（ROM）的发展情况，及其与粗大运动功能和脑瘫亚型的关系。
总共分析了1990年至1999年出生、在满三岁那年居住在瑞典最南部地区且七岁时仍居住在该地区的359名脑瘫儿童。该计划包括对下肢ROM进行角度测量的持续标准化随访。评估由每个孩子的当地物理治疗师进行，6岁前每年两次，之后每年一次。总共分析了1994年至2007年1月1日CPUP数据库中的5075次评估。
研究表明，在2至14岁期间，所有测量的关节或肌肉的平均活动范围均呈下降趋势。ROM的发展因GMFCS水平和脑瘫亚型而异。
我们发现2至14岁的脑瘫儿童ROM下降。这一信息对于个体儿童的治疗和随访计划以及所有脑瘫儿童的医疗保健计划规划都很重要。
