Terms used in this guideline
- Botulinum toxin type A
- Constraint-induced movement therapy
- Continuous pump-administered intrathecal baclofen treatment
- Equinus deformity
- Fine motor function
- Focal dystonia
- Focal spasticity
- Gait analysis
- Gross motor function
- Gross Motor Function Classification System
- Hip migration
- Intrathecal baclofen testing
- Low-load active stretching
- Low-load passive stretching
- Muscle tone
- Network of care
- Network team
- Orthosis (plural, orthoses)
- Passive range of movement
- Range of movement
- Secondary complication of spasticity
- Secondary consequence of spasticity
- Selective dorsal rhizotomy
- Serial casting
- Spinal fusion
- Task-focused active-use therapy
A neurotoxin produced by the bacterium Clostridium botulinum that blocks neurotransmitter release at peripheral cholinergic nerve terminals. Injection into a muscle reduces spasticity.
An approach to physical therapy in which an unaffected arm is temporarily restrained to encourage use of the other arm.
Direct administration of baclofen into the fluid-filled space around the spinal cord (the intrathecal space) using a catheter and infusion pump. The pump is implanted in the abdominal cavity and allows a continual controlled delivery of baclofen adjusted according to need.
Shortening of muscle tendons, ligaments and soft tissues resulting in a limitation of joint movement. Usually, muscle shortening is the primary abnormality, but prolonged immobility or scarring may also contribute.
Involuntary, sustained, or intermittent muscle contractions that cause twitching and repetitive movements, abnormal postures or both.
Abnormal ankle plantarflexion (movement of the foot at the ankle joint in a downward direction). This can, for example, result in the child or young person walking on tiptoe.
The ability to use small muscle groups, often in coordination with the eyes, to perform precision activities such as writing or fastening buttons.
The ability to perform normal activities or actions. Such function may be impaired by spasticity and associated motor disorders and by the complications of spasticity.
A detailed approach to analysing the component phases of walking using instrumentation or video analysis in addition to clinical observation. This is undertaken to evaluate a child or young person's ability and style of walking and to plan or assess treatment.
The ability to use large muscle groups to perform body movements such as sitting, standing, walking and running.
A 5-point scale that describes gross motor function: level I, walks without restrictions; level II, walks without assistive devices; level III, walks with assistive devices; level IV, has limited self-mobility; level V, has severely limited self-mobility even with assistive devices.
Movement of the top of the thigh bone that connects with the pelvis (the femoral head) from its normal position in the socket joint of the hip (the acetabulum). This movement is often measured by reporting the degree of displacement seen on X-ray (known as the hip migration percentage).
Direct injection of baclofen into the fluid-filled space around the spinal cord (the intrathecal space) using a lumbar puncture needle or a temporary spinal catheter in order to assess the likely response to continuous pump-administered baclofen treatment.
Abnormal curvature of the spine when viewed from the side of the body that results in a hunched or slouching position.
A physical therapy intervention in which the child or young person actively stretches their muscles with the aim of increasing range of movement.
A physical therapy intervention involving sustained stretching using positioning with equipment, orthoses or serial casting.
The normal state of continuous passive partial contraction in a resting muscle. Muscle tone is important in maintaining posture. Increased muscle tone (hypertonia) is associated with an abnormal resistance to passive stretch, while reduced muscle tone (hypotonia) is associated with floppiness of the limbs or trunk and poor posture.
Linked groups of healthcare professionals and organisations working in an agreed and coordinated manner to deliver a clinical service. A network is not constrained by existing professional, organisational or institutional boundaries.
A multidisciplinary group of healthcare and other professionals working in a network of care to deliver a clinical service.
An artificial device or appliance used to support, align, prevent, or correct deformities or to improve musculoskeletal function.
The degree of motion through which a joint can be moved by an outside force without active participation by the child or young person themself (for example, movement by another person).
An abnormal lateral curvature of the spine viewed from in front of or behind the child or young person.
An adverse effect on musculoskeletal structure that occurs as a result of spasticity (for example, a contracture or abnormal torsion).
Any effect experienced by a child or young person as a result of spasticity. This may be symptomatic (for example, pain or difficulty walking) or a complication affecting the structure of the musculoskeletal system (see secondary complication of spasticity).
A neurosurgical procedure in which some of the sensory nerves that contribute to spasticity in the lower limb are cut at the point where they enter the spinal cord.
The successive use of casts with the aim of progressively lengthening muscles and other non-bony tissues such as ligaments and tendons thereby reducing the effect of contractures by passive stretching to gradually improve the range of movement.
A specific form of increased muscle tone (hypertonia) in which one or both of the following are present:
the resistance to externally imposed movement increases with increasing speed of stretch and varies with the direction of joint movement
the resistance to externally imposed movement increases rapidly beyond a threshold speed or joint angle.
A surgical procedure where two or more vertebrae are joined to prevent movement between them.