Postural deficits in CP can contribute to which ROM limitation mechanism?

• A. Chronic abnormal postures can lead to muscle shortening and reduced ROM.
• B. Postural deficits do not affect ROM.
• C. ROM is purely determined by joint structure independent of posture.
• D. ROM is only influenced by genetics.

Answer: (A)

Chronic abnormal postures in cerebral palsy lead to adaptive shortening of muscles and connective tissues around joints, so the muscles and fascia lose length and become stiffer over time. When a limb is held in a shortened position for long periods, the muscle-tendon units and joint soft tissues shorten, reducing their ability to lengthen and thereby lowering the passive range of motion. This contracture-like change is a tissue property issue, not just a matter of joint bones or ligaments being inherently fixed, and it explains why ROM limits appear even if the joint itself isn’t structurally damaged. Postural deficits do affect ROM, and ROM is not determined solely by joint structure or by genetics, so those options don’t fit the observed mechanism. Clinically, addressing ROM in CP involves strategies to lengthen or maintain length of the affected muscles and improve tissue elasticity through stretching, positioning, and in some cases serial casting or orthotics, alongside functional training.