In cerebral palsy, testing for equinus is best performed under general anesthesia because the equinus is spastic.

In cerebral palsy, testing for equinus is best performed under general anesthesia because the equinus is spastic.

• A. Because the spastic equinus cannot be reliably assessed in an awake patient
• B. Because general anesthesia permanently relaxes muscles for measurement
• C. Because the test requires continuous monitoring of vital signs
• D. Because results require sedation

Answer: (A)

Testing for equinus in cerebral palsy is best done under general anesthesia because the spastic component makes the ankle’s resistance to stretch unreliable when the patient is awake. Spastic equinus is dynamic and often increases with stretch and reflex activity, so trying to measure true passive ankle dorsiflexion in an awake person mixes a fixed mechanical limitation with variable muscle tone and patient effort. Under general anesthesia, muscle tone is markedly reduced, allowing the clinician to assess the actual passive range of motion of the ankle. If the ankle can be dorsiflexed more fully under anesthesia, the deformity is more likely due to spasticity rather than a fixed contracture; if the range remains limited, a true contracture is present and may require specific lengthening procedures. The other choices aren’t the core reason: general anesthesia doesn’t permanently relax muscles, and the test isn’t about continuous vital-sign monitoring or mere sedation.