The document discusses common muscle disorders in pediatrics and contracture deformities. It covers several genetic muscle disorders including Duchenne muscular dystrophy, spinal muscular atrophy, and different types of muscular dystrophy. It then focuses on contracture deformities, defined as stiffness or constriction in connective tissues that limits range of motion. Common causes in children include inactivity, injury, burns, and genetic disorders like muscular dystrophy or cerebral palsy. Physiotherapy is a primary treatment using exercises and stretches to improve mobility and prevent further contractures.

1. Common muscle
disorders in pediatrics

2. Common muscle disorders
• Duchenne muscular dystrophy (DMD): This is a
genetic disorder characterized by progressive
muscle weakness and wasting. It primarily affects
boys and typically becomes evident in early
childhood.

3. • Spinal muscular atrophy (SMA): SMA is a genetic
disorder that affects the motor neurons in the spinal
cord, leading to muscle weakness and atrophy. There
are different types of SMA, with varying degrees of
severity.
• Cerebral palsy (CP): CP is a group of disorders that
affect movement and posture. It is caused by damage
to the developing brain, often before or during birth.
Symptoms can range from mild to severe and may
include muscle stiffness, spasticity, or involuntary
movements.
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4. • Myasthenia gravis (MG): MG is an autoimmune
disorder that affects the neuromuscular junction,
causing muscle weakness and fatigue. It can occur in
children and is more common in older children and
teenagers.
• Congenital myopathies: These are a group of genetic
disorders that affect the structure or function of
muscles. They can cause muscle weakness, low
muscle tone, and delayed motor development.
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5. • Muscular dystrophy (MD): MD refers to a group of
genetic disorders characterized by progressive muscle
weakness and degeneration. There are different
types of MD, including Duchenne and Becker
muscular dystrophy, which primarily affect boys.
• Myotonic dystrophy: This is an inherited disorder
that affects muscle function and can cause muscle
weakness, myotonia (prolonged muscle contractions),
and other symptoms. It can manifest in childhood or
adulthood.
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6. • Polymyositis: Polymyositis is an inflammatory
muscle disease that can occur in children. It causes
muscle weakness, pain, and inflammation.
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7. • Common symptoms include;
• Muscle weakness.
• Numbness or loss of sensation.
• Muscle atrophy.
• Loss of balance and motor control.
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8. Contracture Deformities
• What are contractures?
• A muscle contracture, or contracture deformity, is the result of
stiffness or constriction in the connective tissues of the body.
• This can occur in:Muscles, (including tendons & ligaments).
• A muscle contracture involves the shortening and tightening of
the muscles joints.
• contracture in the joint capsule where two or more bones
connect, causes limited range of motion in that area of the body.
• Skin may contract where it’s been scarred from an injury, burn, or
past surgery.
• This will limit ability to move that part of the body.

9. Signs of contracture deformity
• Contracture deformity restricts normal movement.
• It develops when the usually pliable connective tissues
become less flexible, range of motion will be limited and
difficulty of moving one or several parts of their body.
• Typical areas of contractures in babies and children are:
• The neck (if they have a preference to tilt or turn their head to
one side)
• Elbows, wrists, fingers & thumbs
• Knees & ankles
• The main symptom of contracture deformity is reduced ability
to move an area of the body.
• The child might also have pain, depending on the location and
cause of the problem.

10. Common causes of contracture
deformity
• The most common causes of contracture are inactivity and
scarring from an injury, surgery or burns.
• Children who have other conditions that keep them from
moving around are also at higher risk for contracture
deformity.
• For example, children that have had a significant amount of
time unwell and immobile following injury or illness, or
following a long hospital stay are at risk of developing
contractures.
• Since they aren’t moving their muscles and joints through
their normal range of motion, these tissues are prime
candidates for tightening.
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11. • Other causes include conditions that are inherited
or that develop in early childhood, such as:
• Muscular dystrophy:Children with this condition
often experience muscle tightness because
significantly weak muscles impair their ability to
move.

12. • Muscular dystrophy is a group of genetic disorders
characterized by progressive muscle weakness and
degeneration.
• It can lead to muscle contractures in pediatrics as the
disease progresses.
• Muscular dystrophy affects the muscles responsible for
movement, causing them to weaken and eventually atrophy.
• This can result in joint stiffness and limited range of motion.
• As the muscles become weaker, they are more prone to
tightening and contracting, leading to muscle contractures.
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13. • Cerebral palsy (CP). This condition causes muscle
tightness and limits movement.
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14. • Arthrogryposis. Children with this condition are
born with/develop joint stiffness with flexed or
straight joints (predominantly elbows and knees).
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• Arthrogryposis can be caused by a variety of
factors, including genetic mutations, maternal
infections during pregnancy, or problems with fetal
movement in the womb.
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15. • The specific joints affected and the severity of
contractures can vary widely in arthrogryposis.
• Commonly affected joints include the shoulders,
elbows, wrists, hips, knees, and ankles.

16. • Juvenile Rheumatoid Arthritis (JIA) or other
inflammatory conditions often cause stiffness in
joints as a result of inflammation, pain and avoiding
movement.

17. When to seek help
• If child gets burned or injured, seek immediate
medical assistance.
• if their ability to move the affected part of their
body is suddenly limited.
• for chronic diseases and underlying conditions as
mentioned previously as early treatment can help
decrease or prevent symptoms.

18. Physiotherapy treatment
• Physiotherapy is the most common treatment for
contractures.
• treat children with contractures.
• provide thorough assessments and hands-on therapy
to improve child’s mobility as well as increase range
of motion in muscles and joints and strengthen
muscles
• Advice programme of exercises that caregivers can
do at home with the child.
• advise on walking aids (such as a walking frame or
walking sticks) if needed.
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19. • physical therapy, stretching exercises, and
orthopedic interventions.
• Physical therapy aims to maintain flexibility and
range of motion in the affected muscles.
• Stretching exercises can help prevent further
contractures and maintain joint mobility..
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20. Other treatments
• The child may need to wear a cast or splint to help stretch
the tissues near the problem area.
• Surgery may be indicated to release severe contractures and
lengthen muscles which aims to increase range of
movement and/or decrease pain.
• Surgery may also be needed to repair ligaments, tendons, or
bones damaged in an accident.
• medication can be perscrcribed to reduce inflammation,
pain or decrease muscle spasms.
• For children with cerebral palsy (or other conditions causing
spasticity), botulinum toxin (Botox) is sometimes injected
into muscles to reduce tension and minimize muscle
spasms.

21. • In some cases, orthopedic interventions may be
necessary to address severe contractures.
• This can include the use of splints, braces, or serial
casting to gradually stretch and correct joint
positions.
• Surgical procedures may be considered in certain
situations to release tight muscles or correct
skeletal abnormalities.
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22. Consequences of delaying treatment
• Delaying or declining treatment may make it difficult
or impossible for your child to regain range of
motion.
• Stiff muscles, joints, and skin can interfere with
performing everyday tasks at home and at school as
well as play.
• For children with diseases such as cerebral palsy,
muscular dystrophy, and JIA (to name a few),
continual medical care is recommended to maximize
available treatment options and their benefits.
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23. Preventing contracture deformity
• Regular exercise and an active lifestyle can help
prevent muscle and joint stiffness