Range of Motion Limitations in Middle-aged Adults With Cerebral Palsy.
Ann-Louise Wibeck, Kate Himmelmann, Ulrica Jonsson and 1 others
PMID 38163028WHAT IT FOUND
Middle-aged adults with cerebral palsy have widespread joint mobility limitations, especially in the hips and shoulders.
These restrictions are more severe in those with higher GMFCS levels and dyskinetic CP, but do not worsen with age in this group.
Key findings
01Limited range of motion was common, with 97 of 150 participants having at least five moderate or severe limitations.
02Limitations were most severe in the lower extremities, particularly affecting the hamstrings (52% moderate/severe) and hip abduction/internal rotation.
03Range of motion limitations correlated with GMFCS level but did not increase with age in this middle-aged cohort.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is cross-sectional, so it cannot track changes in ROM within individuals over time. There was an over-representation of participants with dyskinetic CP compared to the general CP population. Hip extension and ankle dorsiflexion with a straight knee were excluded from the summed score due to high rates of missing data (20%), often caused by pain or inability to assume the starting position. Participants with unilateral spastic CP were measured bilaterally, so the unaffected side was included in group data, potentially masking asymmetries. Many participants at GMFCS level V were excluded from the SRL analysis because they could not complete all measurements, which may underestimate the severity of limitations in the most affected group.
Declared interests
The authors declared no conflicts of interest. The study was funded by grants from the Swedish state under the agreement between the Swedish government and the county councils (ALF-agreement), the Swedish Research Council, and the Swedish Society of Medicine.
The easy way to misread this
Do not assume that joint mobility limitations in adults with CP are progressive with age. This study found negligible correlation between age and range of motion limitations in participants aged 37 to 58, suggesting that most restrictions are established earlier in life. Clinicians should focus on managing existing limitations rather than expecting new deterioration solely due to aging.