Klenø André Nis, Stisen Martin Bækgaard, Cubel Claes Høgh, Mechlenburg Inger, Nordbye-Nielsen Kirsten
Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark.
Department of Children's Orthopaedics, Aarhus University Hospital, Aarhus N, Denmark.
Physiother Theory Pract. 2023 Jan;39(1):200-207. doi: 10.1080/09593985.2021.2007558. Epub 2021 Nov 22.
Cerebral palsy (CP) is a neurological disease occurring in children at early gestation, often resulting in pronounced functional limitations. A Swedish cross-sectional study (Cloodt, et al., 2018) discovered that 22% of children with CP had a knee contracture, which was associated with higher levels of Gross Motor Function Classification System (GMFCS), higher age, and higher levels of spasticity measured by the Modified Ashworth Scale (MAS). The current study investigated these associations in a Danish population.
This is a cross-sectional study including 1,163 children with CP aged 0-15 years, registered in the Danish National Cerebral Palsy Registry between 2017 and 2019. Prevalence of knee contracture was estimated, and logistic regression analysis was applied with results presented as odds ratio (OR) with 95% confidence intervals (CI).
A total of 511 children with CP had knee contracture resulting in a prevalence of 44%. Age groups 4-6 years (OR: 1.73, CI: 1.19; 2.52), 7-9 years (OR: 1.85, CI: 1.29; 2.66) and 10-12 years (OR: 2.12, CI: 1.39; 3.24) were significantly associated with a higher prevalence of knee contractures compared to age group 0-3 years. Knee contractures were significantly more frequent at GMFCS levels IV (OR: 1.9, CI: 1.21; 2.97) and V (OR: 3.62, CI: 2.36; 5.55) compared to level I. Knee contractures were not associated with higher levels of MAS.
Knee contractures are highly prevalent and significantly associated with high levels of GMFCS and increased age until 12 years, but not with high levels of spasticity in children with CP in Denmark.
脑瘫（CP）是一种在妊娠早期儿童中发生的神经系统疾病，常导致明显的功能受限。瑞典的一项横断面研究（克洛德特等人，2018年）发现，22%的脑瘫儿童存在膝关节挛缩，这与粗大运动功能分类系统（GMFCS）水平较高、年龄较大以及改良Ashworth量表（MAS）测量的痉挛程度较高有关。本研究在丹麦人群中调查了这些关联。
这是一项横断面研究，纳入了2017年至2019年间在丹麦国家脑瘫登记处登记的1163名0至15岁的脑瘫儿童。估计膝关节挛缩的患病率，并应用逻辑回归分析，结果以比值比（OR）和95%置信区间（CI）表示。
共有511名脑瘫儿童存在膝关节挛缩，患病率为44%。与0至3岁年龄组相比，4至6岁（OR：1.73，CI：1.19；2.52）、7至9岁（OR：1.85，CI：1.29；2.66）和10至12岁（OR：2.12，CI：1.39；3.24）年龄组的膝关节挛缩患病率显著更高。与I级相比，GMFCS IV级（OR：1.9，CI：1.21；2.97）和V级（OR：3.62，CI：2.36；5.55）的膝关节挛缩明显更频繁。膝关节挛缩与较高的MAS水平无关。
在丹麦，脑瘫儿童中膝关节挛缩非常普遍，且与GMFCS高水平和12岁前年龄增加显著相关，但与痉挛程度高无关。
