{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T11:46:11Z","timestamp":1793533571711,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004785","name":"NordForsk","doi-asserted-by":"publisher","award":["82866"],"award-info":[{"award-number":["82866"]}],"id":[{"id":"10.13039\/501100004785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2018\u201001468"],"award-info":[{"award-number":["2018\u201001468"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the relationships between pain in the lower extremities and back, and spasticity, bone\/joint complications and mobility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective population\u2010based registry study. Participants (N\u00a0=\u00a03256) with cerebral palsy (CP), 2.5\u201016\u00a0years of age, participating in the Swedish Cerebral Palsy Follow\u2010up Program were included.<jats:italic>Spasticity<\/jats:italic>was measured using scissoring and the Modified Ashworth Scale.<jats:italic>Bone\/joint complications<\/jats:italic>consisted of hip displacement, range of motion, windswept posture and scoliosis.<jats:italic>Mobility<\/jats:italic>was measured using the Functional Mobility Scale (5\u2010, 50\u2010 and 500\u2010metres), wheelchair use (outdoors) and the ability to stand\/get up from sitting\/use stairs, respectively.<jats:italic>Pain<\/jats:italic>was measured as presence of pain in hips, knees, feet and back. Data were analysed using structural equation modelling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bone\/joint complications had the strongest direct pathway with pain in the lower extremities (standardised regression coefficient\u00a0=\u00a00.48), followed by reduced mobility (standardised regression coefficient\u00a0=\u00a0\u22120.24). The pathways between spasticity and pain, and age and pain were not significant. The R<jats:sup>2<\/jats:sup>of the model was 0.15.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bone\/joint complications and reduced mobility were associated with pain in the lower extremities when controlling for sex. Considering the<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>of the model, other factors not included in the model are also associated with pain in the lower extremities in children with CP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.15006","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T06:18:58Z","timestamp":1568182738000},"page":"541-549","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Bone and joint complications and reduced mobility are associated with pain in children with cerebral palsy"],"prefix":"10.1111","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0878-735X","authenticated-orcid":false,"given":"Steven M.","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Health Sciences Lund University Lund 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