{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:47:58Z","timestamp":1790696878276,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,3,20]],"date-time":"2013-03-20T00:00:00Z","timestamp":1363737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Clinical determination of spasticity is confounded by the difficulty in distinguishing reflex from passive contributions to muscle stiffness. There is, therefore, a risk that children with cerebral palsy (<jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>) receive antispasticity treatment unnecessarily. To investigate this, we aimed to determine the contribution of reflex mechanisms to changes in the passive elastic properties of muscles and tendons in children with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Biomechanical and electrophysiological measures were used to determine the relative contribution of reflex and passive mechanisms to ankle muscle stiffness in 35 children with spastic <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> (21 males, 14 females; mean age 9y, SD 3y 4mo; range 3\u201315y) and 28 control children without <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> (19 males, nine females; mean age 8y 11mo, SD 2y 10mo; range 3\u201315y). Twenty\u2010seven children were diagnosed as having spastic hemiplegia, six with spastic diplegia, and two with spastic tetraplegia. According to the <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ross <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>otor <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>unction <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>lassification System, 31 children were classified in level <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>, two in level <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>, and two in level <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only seven children with spastic <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> showed reflex stiffness outside the range of the control children. In contrast, 20 children with spastic <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> showed abnormal passive muscle stiffness (<jats:italic>p<\/jats:italic>&lt;0.001). No correlation between increased reflex or increased passive muscle stiffness and age was observed within the age range studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>These data suggest that increased reflex\u2010mediated muscle stiffness is difficult to distinguish clinically from changes in passive muscle stiffness and that signs of changes in muscle properties are already present from the age of 3\u00a0years in children with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>. This emphasizes the importance of accurately distinguishing different contributions to muscle stiffness to avoid unnecessary antispasticity treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.12124","type":"journal-article","created":{"date-parts":[[2013,3,20]],"date-time":"2013-03-20T17:39:03Z","timestamp":1363801143000},"page":"617-623","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Passive muscle properties are altered in children with cerebral palsy before the age of 3\u00a0years and are difficult to distinguish clinically from spasticity"],"prefix":"10.1111","volume":"55","author":[{"given":"Maria","family":"Willerslev\u2010Olsen","sequence":"first","affiliation":[{"name":"Department of Exercise and Sport Sciences and Department of Neuroscience and Pharmacology University of Copenhagen Copenhagen Denmark"},{"name":"Helene Elsass Center Charlottenlund 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