{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:08:21Z","timestamp":1790708901969,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the association of anterior pelvic tilt (APT) and other patient risk factors with back pain in adults with cerebral palsy (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a prospective cohort study of adults previously treated at a pediatric specialty center. Inclusion criteria were adults with CP over the age of 24\u2009years, ambulatory Gross Motor Function Classification System (GMFCS) levels I to IV, with at least one instrumented gait analysis during childhood. Kinematic parameters, Patient\u2010Reported Outcomes Measurement Information System pain interference score, walking activity (StepWatch), and Gait Deviation Index were examined as potential risk factors for back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 118 (42% female) participants who met inclusion criteria: GMFCS level I (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a024), II (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a064), III (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a024), IV (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a06); mean age 29\u2009years (SD 4\u2009years), range 24 to 44\u2009years. Prevalence of back pain was 14% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a016). The degree of APT was not significantly different between groups with\/without back pain (19.4 [SD 9.0] vs 20.6 [SD 10.1];\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.64). Regression analysis found that neither APT nor secondary factors were significantly related to back pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Despite clinicians' concerns, excessive APT was not significantly associated with back pain in this cohort of adults with CP. The negative consequences of excessive APT related to back pain may not be as significant as previously thought for people with CP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.70547","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:39:21Z","timestamp":1790707161000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anterior pelvic tilt and back pain in adults with cerebral palsy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1006-0632","authenticated-orcid":false,"given":"Chris","family":"Church","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Hinchberger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Salazar\u2010Torres","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-6465","authenticated-orcid":false,"given":"Nancy","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8207-2109","authenticated-orcid":false,"given":"M. Wade","family":"Shrader","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0033-5623","authenticated-orcid":false,"given":"Freeman","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Nemours Children's Health  Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3049-6345","authenticated-orcid":false,"given":"Jason J.","family":"Howard","sequence":"additional","affiliation":[{"name":"IWK Health Centre, Faculty of Medicine Dalhousie University  Halifax Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"4","key":"e_1_2_8_2_1","first-page":"213","article-title":"Cerebral palsy: an overview","volume":"101","author":"Vitrikas K","year":"2020","journal-title":"American Family Physician"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.70149"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14111"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-012-1720-x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13368"},{"issue":"2","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1080\/16501970310018305","article-title":"Musculoskeletal pain in adults with cerebral palsy compared with the general population","volume":"36","author":"Jahnsen R","year":"2004","journal-title":"Journal of Rehabilitation Medicine"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14678"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","unstructured":"LucasJW ConnorEM BoseJ.Back lower limb and upper limb pain among U.S. adults 2019. 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