{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:14:42Z","timestamp":1790921682184,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010814","name":"Stiftelsen f\u00f6r Bist\u00e5nd \u00e5t R\u00f6relsehindrade i Sk\u00e5ne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010814","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005390","name":"Alfred \u00d6sterlunds Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005390","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We examined how lower limb muscle tone was related to age, sex, Gross Motor Function Classification System (GMFCS) level, and the cerebral palsy (CP) subtype in Swedish children with CP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This registry\u2010based cohort study from 2023 to 2024 used data on all 3 216 children aged 1\u201315 from the Swedish follow\u2010up program and national CP Registry. Muscle tone was assessed with the Ashworth Scale in the gastrocsoleus, hamstring, and adductor muscles. Associations between muscle tone and age, GMFCS level, sex, and CP subtype were analysed using descriptive statistics and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hypertonia, defined as Ashworth grade \u2265\u20091, was present in the gastrocsoleus in 84% of the children, in the hamstrings in 52%, and in the adductors in 34%. Prevalence increased with higher GMFCS levels and varied across age and muscle groups. Gastrocsoleus hypertonia peaked at 7\u20139\u2009years and then declined. Hamstring hypertonia increased steadily up to 13\u201315\u2009years. Adductor hypertonia showed a U\u2010shaped pattern across age groups. Children with bilateral spastic or dyskinetic CP had the highest hypertonia levels in all muscle groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Muscle hypertonia in children with CP varied by age, GMFCS level, CP subtype, and muscle group. This should be considered when planning treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70649","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T13:34:22Z","timestamp":1781357662000},"page":"2261-2268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Swedish Population\u2010Based Study Found That Muscle Hypertonia in Children With Cerebral Palsy Varied by Age, Subtype, Functional Level, and Muscle Group"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9593-4927","authenticated-orcid":false,"given":"Gunnar.","family":"H\u00e4gglund","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Orthopaedics Sk\u00e5ne University Hospital  Lund Sweden"},{"name":"Lund Disability Research Hub  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9430-263X","authenticated-orcid":false,"given":"Ann. I.","family":"Alriksson\u2010Schmidt","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Orthopaedics Sk\u00e5ne University Hospital  Lund Sweden"},{"name":"Lund Disability Research Hub  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.30.12.1303"},{"key":"e_1_2_14_3_1","first-page":"107","volume-title":"Cerebral Palsy, 2005","author":"Miller F.","year":"2005"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2011.618917"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199307000-00013"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14368"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2000.tb00695.x"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1590769"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.2340\/17453674.2024.40606"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2016.1161843"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/67.2.206"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03089.x"},{"key":"e_1_2_14_13_1","unstructured":"CPUP (Cerebral Palsy Follow\u2010Up Program) Manuals and Evaluation Formsaccessed at June 11 2026 https:\/\/cpup.se\/in\u2010english\/manuals\u2010and\u2010evaluation\u2010forms\/."},{"key":"e_1_2_14_14_1","first-page":"540","article-title":"Preliminary Trial of Carisoprodol in Multiple Sclerosis","volume":"192","author":"Ashworth B.","year":"1964","journal-title":"Practitioner"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1992.tb11479.x"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401203300308"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-9-150"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-019-1891-y"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12614"},{"key":"e_1_2_14_20_1","unstructured":"G.H\u00e4gglundandA.Alriksson Schmidt Treatment with Botulinum toxin A in the lower extremities in children with cerebral palsy \u2013 a Swedish population\u2010based registry study 2025."},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-9-44"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.17.04796-7"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162206000132"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.26070"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(98)90095-8"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70649","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.70649","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:48:15Z","timestamp":1788882495000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":24,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/apa.70649"],"URL":"https:\/\/doi.org\/10.1111\/apa.70649","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"assertion":[{"value":"2026-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}