Palisano R J, Walter S D, Russell D J, Rosenbaum P L, Gémus M, Galuppi B E, Cunningham L
Department of Rehabilitation Sciences, MCP Hahnemann University, Philadelphia, PA 19102-1192, USA.
Arch Phys Med Rehabil. 2001 Apr;82(4):494-500. doi: 10.1053/apmr.2001.21956.
To create gross motor function growth curves for children with Down syndrome (DS) and to estimate the probability that motor functions are achieved by different ages.
Nonlinear growth curve analysis by using a 2-parameter (rate, upper limit) model.
Early intervention programs, schools, and children's homes.
One hundred twenty-one children with DS, ages 1 month to 6 years.
Gross Motor Function Measure (GMFM) and severity of motor impairment.
The curves for children with mild (n = 51) and moderate/severe (n = 70) impairment were characterized by a greater increase in GMFM scores during infancy and smaller increases as the children approached the predicted maximum score of 85.9 or 87.9. The estimated probability that a child would roll by 6 months was 51%; sit by 12 months, 78%; crawl by 18 months, 34%; walk by 24 months, 40%; and run, walk up stairs, and jump by 5 years, 45% to 52%.
Children with DS require more time to learn movements as movement complexity increases. Impairment severity affected the rate but not the upper limit of motor function. The results have implications for counseling parents, making decisions about motor interventions, and anticipating the time frame for achievement of motor functions.
绘制唐氏综合征（DS）患儿的粗大运动功能生长曲线，并估计不同年龄实现运动功能的概率。
采用双参数（速率、上限）模型进行非线性生长曲线分析。
早期干预项目、学校和儿童福利院。
121名DS患儿，年龄1个月至6岁。
粗大运动功能测量（GMFM）和运动障碍严重程度。
轻度（n = 51）和中重度（n = 70）损伤患儿的曲线特点是，婴儿期GMFM评分增加幅度较大，而随着患儿接近预测的最高分85.9或87.9，增加幅度变小。估计患儿在6个月时会翻身的概率为51%；12个月时会坐的概率为78%；18个月时会爬行的概率为34%；24个月时会走路的概率为40%；5岁时会跑、上楼梯和跳跃的概率为45%至52%。
随着运动复杂性增加，DS患儿学习动作需要更多时间。损伤严重程度影响运动功能的速率，但不影响上限。研究结果对指导家长、制定运动干预决策以及预测运动功能实现的时间框架具有重要意义。
