van Eck Mirjam, Dallmeijer Annet J, Voorman Jeanine M, Becher Jules G
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Dev Med Child Neurol. 2009 Apr;51(4):303-10. doi: 10.1111/j.1469-8749.2008.03263.x.
The aim of this study was to describe the course of motor performance and analyse its relationship with motor capacity over a period of 3 years in 104 children (66 males, 38 females; 43% of those initially invited) with cerebral palsy (CP) aged 9, 11, and 13 years at the start of the study. Forty-one had hemiplegia, 42 diplegia, 21 tetraplegia; 83 spastic CP, 17 dyskinetic/mixed, and four ataxic CP. Gross Motor Function Classification System (GMFCS) levels were I, n=49; II, n=15; III, n=10; IV, n=12; and V, n=18.
Motor performance (what a child does do) was determined using the gross motor skills subscale of the Vineland Adaptive Behavior Scales and motor capacity [what a child can do] was determined using the Gross Motor Function Measure-66 (GMFM-66). The measurements were performed annually over a period of 3 years.
The course of motor performance in mildly affected children (GMFCS level I) was more favorable than in more severely affected children. An increase in motor capacity was significantly related to an improvement in motor performance over the 3 years.
Training motor capacity in children with CP seems to be important for improving motor performance. Interventions should also focus on environmental adaptations and improving mobility equipment. A limitation of this study was that the instruments used did not contain the same items on capacity and performance level.
本研究旨在描述104名脑瘫(CP)儿童(66名男性,38名女性;占最初受邀儿童的43%)在3年期间的运动表现过程,并分析其与运动能力的关系。这些儿童在研究开始时年龄分别为9岁、11岁和13岁。其中41名偏瘫,42名双瘫,21名四肢瘫;83名痉挛型CP,17名运动障碍/混合型,4名共济失调型CP。粗大运动功能分类系统(GMFCS)水平为:I级,n = 49;II级,n = 15;III级,n = 10;IV级,n = 12;V级,n = 18。
使用文兰适应行为量表的粗大运动技能分量表确定运动表现(儿童实际能做的事情),使用粗大运动功能测量-66(GMFM-66)确定运动能力(儿童能够做的事情)。在3年期间每年进行测量。
轻度受影响儿童(GMFCS I级)的运动表现过程比重度受影响儿童更有利。在3年期间,运动能力的提高与运动表现的改善显著相关。
对CP儿童训练运动能力似乎对改善运动表现很重要。干预措施还应侧重于环境适应和改进移动设备。本研究的一个局限性是所使用的工具在能力和表现水平方面没有包含相同的项目。