Hesperian Health Guides
Contractures in Cerebral Palsy
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Abnormal muscle tightness often leads to contractures (muscle shortening and reduced motion of joints). In time, the muscles that keep a limb bent become shortened so that the limb cannot straighten even when the muscles relax. But with care, contractures can often be prevented.
|(Uncontrolled tightening of muscles||——— >||(Fixed shortening of muscles)|
The typical contractures of cerebral palsy are similar to the abnormal positions of cerebral palsy. They can include:
neck contractures that pull the head back or to one side
An arm and hand that are always bent may cause contracture of elbow and wrist.
Ankle and foot contractures may bend IN, DOWN, UP or OUT depending on the spasticity.
Stretching the knees apart you can see and feel the very tight cord in the groin.
Spasticity and contractures combined
Decreased range of motion may be caused partly by spasticity and partly by contractures. Therefore, whenever a child has spasticity, check to see if contractures are also forming, and if so, how much.
|This girl with cerebral palsy has spastic muscles that hold her knees tightly together.||
When she is helped to relax and her legs are slowly separated, they will only open this far.
|Normally her legs should open this far. This means she has contractures on the inner side of her thighs (groin).|
|One way to record spasticity and contractures:|
|You can use a flexikin to record the positions.|