DOS 2017

DOS Kongressen 2017 ·

Passive range of motion and clinical cut-off point of in

ankle dorsiflexion are not correlated with gross motor

function in children with cerebral palsy – a cross sec-

tional study

Helle Mätzke Rasmussen, Joachim Svensson, Maria Thorning, Niels Wisbech

Pedersen, Søren Overgaard, Anders Holsgaard-Larsen

The Orthopedic Research Unit, 1) Department of Orthopedic Surgery and Trau-

matology, Odense University Hospital, Denmark 2) Department of Clinical Re-

search, University of Southern Denmark, Odense, Denmark

Background:

The Cerebral Palsy follow Up Program (CPOP) uses cut-off points

(traffic light signals) to categorize passive range of motion (ROM) in: green, yel-

low and red in order to guide clinical decisions. The cut-off points are not evi-

dence based and potential relationship with gross motor capacity and patient-

reported gross motor function has never been established.

Purpose / Aim of Study:

To investigate ROM and the traffic light categories

for ankle dorsiflexion and their relationship with gross motor function in children

with cerebral palsy (CP).

Materials and Methods:

We conducted a cross-sectional study of 60 children

with spastic CP at GMFCS level I-II, aged 5-9 years. ROM were measured as

maximal ankle dorsiflexion with flexed and extended knee using goniometry and

the categories applied using the cut-off points provided by CPOP. Furthermore

1-min walking distance (1-min walk), Gross Motor Function Measure (GMFM)

and Pediatric Quality of Life Inventory Cerebral Palsy Module: movement and

balance subscale (Pedsql) where collected. Correlations where investigated with

Pearson correlation coefficients. Differences in the three groups based on the

traffic light categories were investigated with one-way ANOVA.

Findings / Results:

No significant correlation (r2 < 0.2, p>0.05) where docu-

mented between ROM versus 1-min walk, GMFM and Pedsql. Furthermore, the

group mean values of the outcome measures in the traffic light categories did

not differ.

Conclusions:

Ankle dorsiflexion are not correlated with gross motor function,

why the cut-off points used in CPOP are of limited clinical value in relation to

gross motor capacity and patient-reported impairments in relation to move-

ment and balance. As a consequence ROM and gross motor function may be

considered as separate constructs, which may have impact on the decision-

making of treatment for the patient group.

No conflicts of interest reported

49.