Hip contractures were associated with low gross motor function in children with cerebral palsy
Inger Mechlenburg1,2,3, Malene Tousgaard Foget Østergaard1, Christina Bach Menzel1
1Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark.
Insights
Hip contractures are common in children with cerebral palsy (CP), affecting 22% of those studied. These contractures are linked to reduced gross motor function, particularly in severe cases, but not to lower extremity pain.
Area of Science:
- Pediatrics
- Orthopedics
- Neurology
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture.
- Hip contractures are a common complication in children with CP, potentially impacting their motor function.
- Understanding the prevalence and associations of hip contractures is crucial for clinical management.
Purpose of the Study:
- To determine the prevalence of hip contractures in Danish children with CP.
- To investigate the association between hip contractures and gross motor function.
- To examine the relationship between hip contractures and lower extremity pain.
Main Methods:
- Cross-sectional study using data from the National Danish Clinical Quality Database (2018-2019).
- Included 688 children aged 5-12 years with CP across all Gross Motor Function Classification System (GMFCS) levels.
- Logistic regression analysis was used to assess associations, with results presented as odds ratios (OR) and 95% confidence intervals (95% CI).
Main Results:
- The overall prevalence of hip contracture was 22% across all GMFCS levels.
- Significantly higher odds of hip contracture were observed in GMFCS levels IV (OR 1.99) and V (OR 5.49) compared to level I.
- No significant association was found between hip contractures and lower extremity pain (OR 1.43).
Conclusions:
- Hip contractures are a frequent condition in children with CP.
- Hip contractures are strongly associated with impaired gross motor function, especially at higher GMFCS levels.
- Lower extremity pain was not significantly associated with hip contractures in this cohort.
Aim:
The aim was to identify the prevalence of hip contractures and their association with gross motor function and pain in the lower extremities among Danish children with cerebral palsy (CP).
Methods:
This cross-sectional study was based on data collected during regular clinical examinations in 2018-2019 and registered in the National Danish Clinical Quality Database of children with CP. The study population was 688 children (59% boys) aged five to 12 years across all Gross Motor Function Classification System (GMFCS) levels. Any associations between hip contracture and gross motor function and pain were investigated with logistic regression analysis and presented as odds ratios (OR) with 95% confidence intervals (95% CI).
Results:
The prevalence of hip contracture was 22% across all five GMFCS levels, and the incidence varied across the five Danish regions. The odds ratios for hip contracture were significantly higher at GMFCS level IV (OR 1.99, 95% CI 1.10-3.62) and V (OR 5.49, 95% CI 3.33-9.07) compared with level I. Hip contractures were not significantly associated with pain in the lower extremities (OR 1.43, 95% CI 0.95-2.15).
Conclusion:
Hip contractures were frequent and associated with low gross motor function, but not lower extremity pain, in children with CP.
