Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Acta Paediatr. 2021 Jul;110(7):2171-2178. doi: 10.1111/apa.15804. Epub 2021 Feb 24.
To estimate yearly prevalence of ankle contractures among children with cerebral palsy (CP). Moreover, to investigate whether age, gross motor function or spasticity are associated with ankle contracture.
We examined yearly prevalence of ankle contractures among 933 children based on data from a national clinical quality database from 2012 to 2019. We used the Gross Motor Function Classification System (GMFCS) and the Modified Ashworth Scale (MAS) to assess gross motor function and spasticity in the plantar flexors. Ankle contracture was defined as dorsiflexion with an extended knee equal to or below 0 degrees. Associations between age, GMFCS, spasticity and ankle contractures were analysed using multivariable regression and presented as odds ratios (OR) with 95% confidence intervals (95%CI).
The prevalence of ankle contracture was 32% and did not change with calendar year. GMFCS IV-V compared to I-III (40.6% vs. 28.9%, OR = 1.5 (95%CI: 1.07-2.11) and MAS 2-4 compared to 0 (44.6% vs. 24.4%, OR = 2.5 (95%CI: 1.59-3.91) were associated with a higher prevalence of ankle contracture. Age was not associated with ankle contracture.
Ankle contractures are frequent among children with CP. Lower gross motor function and severe spasticity were associated with ankle contracture.
估计脑瘫（CP）儿童踝关节挛缩的年患病率。此外，还研究了年龄、粗大运动功能或痉挛与踝关节挛缩的关系。
我们根据 2012 年至 2019 年全国临床质量数据库的数据，检查了 933 名儿童的踝关节挛缩年患病率。我们使用粗大运动功能分类系统（GMFCS）和改良 Ashworth 量表（MAS）评估跖屈肌的粗大运动功能和痉挛。踝关节挛缩定义为膝关节伸展时背屈等于或低于 0 度。使用多变量回归分析年龄、GMFCS、痉挛与踝关节挛缩之间的关系，并以 95%置信区间（95%CI）表示为优势比（OR）。
踝关节挛缩的患病率为 32%，且不随日历年度变化。与 GMFCS I-III 相比，GMFCS IV-V（40.6%比 28.9%，OR=1.5（95%CI：1.07-2.11）和 MAS 2-4 比 0（44.6%比 24.4%，OR=2.5（95%CI：1.59-3.91）与踝关节挛缩的高患病率相关。年龄与踝关节挛缩无关。
踝关节挛缩在脑瘫儿童中很常见。较低的粗大运动功能和严重的痉挛与踝关节挛缩有关。
