Both spasticity and contractures can cause joint subluxations or dislocations and severe gait difficulties. Severe cases may result in contractures (joint deformities). Neglected or inappropriately treated spasticity can eventually lead to joint contractures. Clinical features include hypotonia, areflexia, and multiple congenital contractures. Other musculoskeletal complications may include joint contractures, muscle weakness or muscle wasting. These can cause congenital contractures, including clubfoot, in distal arthrogryposis (DA) syndromes. Associated problems may include problems with swallowing, scoliosis, and joint contractures. Over time, deformities tend to become static, and joint contractures develop. Other physical impairments include joint contractures due to long periods of immobility while hospitalized. Surgical interventions may be needed to correct contractures or scoliosis. Cited advantages include maintenance of finger extension and prevention of new flexion contractures. Serial casting and splinting are often used to reduce soft tissue contractures and muscle tone. Other complications include swelling, muscle transfixion, and joint contractures. In principle&colon; any factor that curtails fetal movement can result in congenital contractures. Exercise programs, along with manual therapy, will help to prevent muscle contractures, spasms and atrophy.