Contractures in Cerebral Palsy

This content is from page 101 of Disabled Village Children

Severe 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.

Without care to prevent it:

SPASTICITY	leads to	CONTRACTURE
(Uncontrolled tightening of muscles	——— >	(Fixed shortening of muscles)

The typical contractures of cerebral palsy are similar to the unhealthy positions of cerebral palsy. They can include:

neck contractures that pull the head back or to one side

sway back

bent-hip contracture

bent-knee contracture

‘tiptoe’ contracture

An arm and hand that are always bent may cause contracture of elbow and wrist.

‘knock-knees’ contracture

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.

Chapter 8 discusses contractures, and ways to prevent and correct them. See how to tell spasticity from contractures.

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 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.
		Typically her legs should open this far. This means she has contractures on the inner side of her thighs (groin).