Relationship between scoliosis, windswept hips and contractures with pain and asymmetries in sitting and supine in 2450 children with cerebral palsy

Jackie Casey, Atli Agustsson, Andreas Rosenblad, Elisabet Rodby-Bousquet

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
1 Downloads (Pure)

Abstract

Purpose
This cross-sectional study of 2450 children with cerebral palsy aimed to analyse the prevalence and association of scoliosis, windswept hips, hip and knee contractures.

Methods
Logistic regression was used to estimate associations with pain, postural asymmetries, and ability to change position for children at Gross Motor Function Classification System (GMFCS) levels I–V, aged 0–18 years.

Results
Most children with a deformity or contracture had postural asymmetries in both sitting and supine positions; 10.5% had scoliosis, 8.7% windswept hips, 6.6% hip flexion and 19.2% knee contractures. Severe postural asymmetries increased the likelihood for scoliosis 9 times, for windswept hips 6 to 9 times, and for hip and knee flexion contractures 7 and 12 times respectively, adjusted for age, sex and GMFCS level. Hip flexion contractures and windswept hips increased the likelihood for pain by 1.5–1.6 times.

Conclusion
The likelihood of having scoliosis, windswept hips and flexion contractures in the hips and knees increased if the child had postural asymmetries, and for increased age and higher GMFCS levels. Efforts should focus on preventing postural asymmetries from occurring or progressing, and on increasing the child’s ability to change position. Reducing postural asymmetries may also reduce the likelihood of pain.

Implications for Rehabilitation
The risk of having scoliosis, windswept hip deformity and flexion contractures in the hips and knees increased if the child had postural asymmetries in sitting or lying.
Efforts should focus on preventing or reducing postural asymmetries, and on increasing the child’s ability to change position.
Reducing postural asymmetries may also reduce the risk of pain.
Original languageEnglish
Pages (from-to)6738-6743
Number of pages6
JournalDisability and Rehabilitation
Volume44
Issue number22
Early online date6 Sept 2021
DOIs
Publication statusPublished (in print/issue) - 23 Oct 2022

Keywords

  • Cerebral palsy
  • hip
  • knee
  • pain
  • posture
  • scoliosis
  • sitting position
  • supine position

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