Palisano Robert J, Tieman Beth L, Walter Stephen D, Bartlett Doreen J, Rosenbaum Peter L, Russell Diane, Hanna Steven E
Drexel University, Programs in Rehabilitation Sciences, Philadelphia, PA 19102-1192, USA.
Dev Med Child Neurol. 2003 Feb;45(2):113-20.
The aim of this study was to: (1) describe the usual mobility methods of children with cerebral palsy (CP) at home, school, and outdoors or in the community and (2) examine whether children with CP are more dependent on adult assistance for mobility in certain settings. The participants were a stratified random sample of 636 children with CP (355 males and 281 females; 2 to 12 years of age, mean 6.8 years SD 2.7), receiving rehabilitation services in Ontario, Canada. Children were grouped by age and Gross Motor Function Classification System (GMFCS) level. Among the five levels of the GMFCS, there were 185 children classified at level I, 81 children at level II, 113 children at level III, 132 children at level IV, and 125 children at level V. Information on children's usual mobility was obtained by parent report. The results of logistic regression indicated that compared with the school setting, children were more dependent on adult assistance for mobility when outdoors/in the community and less dependent at home. The majority of children aged from 4 to 12 years at levels III to V used wheelchair mobility at school and outdoors or in the community, however, only a small percentage self-propelled their wheelchair or used powered mobility. Of the children aged 4 to 12 years at level V, 39% were carried at home. The findings suggest that environmental setting is an important consideration for assessment and intervention to improve mobility of children with CP. For children who do not walk, attention should be given to the needs of caregivers and factors that are important for successful powered mobility.
（1）描述脑瘫（CP）儿童在家中、学校、户外或社区的常用移动方式，以及（2）研究CP儿童在某些环境中移动时是否更依赖成人协助。参与者是从加拿大安大略省接受康复服务的636名CP儿童中分层随机抽取的样本（355名男性和281名女性；年龄在2至12岁之间，平均6.8岁，标准差2.7）。儿童按年龄和粗大运动功能分类系统（GMFCS）水平分组。在GMFCS的五个级别中，I级有185名儿童，II级有81名儿童，III级有113名儿童，IV级有132名儿童，V级有125名儿童。关于儿童常用移动方式的信息通过家长报告获得。逻辑回归结果表明，与学校环境相比，儿童在户外/社区移动时更依赖成人协助，而在家中则依赖性较小。III至V级4至12岁的大多数儿童在学校、户外或社区使用轮椅移动，然而，只有一小部分儿童自行推动轮椅或使用电动移动设备。V级4至12岁的儿童中，39%在家中由人抱持。研究结果表明，环境设置是评估和干预以改善CP儿童移动能力的重要考虑因素。对于不能行走的儿童，应关注照顾者的需求以及对成功使用电动移动设备至关重要的因素。
