Mobility and joint range of motion in adults with cerebral palsy: A population-based study

Abstract

Objective. The aim of this study was to describe the methods of mobility used in the community in relation to subtypes of cerebral palsy (CP), level of gross motor function and passive joint range of motion (PROM) in the lower limbs in young adults. Methods. From a total population of people with CP, 102 young adults (63 males) aged 18–23 years (median 20 years) participated. All subtypes were represented and the Gross Motor Function Classification System Expanded and Revised (GMFCS-E&R) levels were I n = 38, II n = 21, III n = 13, IV n = 10 and V n = 20. The Functional Mobility Scale 500 metres (FMS500m) level was analysed in relation to PROM using chi-squared tests. Relative risk was used to investigate the relationship between PROM and mobility. Results. All participants either walked without aids or used a wheelchair to move or transport themselves 500 m. Significant associations were found between FMS500m and PROM in the knee and ankle joints. Limited PROM in popliteal angle and knee extension was associated with use of a wheelchair, while limited foot dorsiflexion was associated with walking without support in the community. Conclusion. Method of mobility was associated with PROM of the knee and ankle joints for all GMFCS-E&R levels and subtypes of CP. To be able to continue to walk in adulthood, successful prevention of severe knee contractures, and avoiding excessive lengthening of the calf muscles and tendons, seem important for children with CP who are able to walk.