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痉挛型四肢瘫脑瘫学龄前儿童随访研究中发育状况与步行能力的关系

Relationships between developmental profiles and ambulatory ability in A follow-up study of preschool children with spastic quadriplegic cerebral palsy.

作者信息

Chen Chia-Ling, Chen Chung-Yao, Lin Keh-Chung, Chen Kai-Hua, Wu Ching-Yi, Lin Chu-Hsu, Liu Wen-Yu, Hsu Hung-Chih

机构信息

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taipei, Graduate Institute of Occupational Therapy, College of Medicine, NationalTaiwan University, Taipei, Taiwan.

出版信息

Chang Gung Med J. 2010 Sep-Oct;33(5):524-31.

Abstract

BACKGROUND

To investigate the follow-up course of developmental profiles in preschool children with spastic quadriplegic (SQ) cerebral palsy (CP) who had varying ambulatory abilities.

METHODS

Forty-eight children with SQ CP between 1 and 5 years old were classified into 2 groups, the ambulatory and non-ambulatory groups, based on Gross Motor Function Classification System (GMFCS) levels during the initial assessment. The developmental profiles, consisting of development quotients (DQs) of 8 domains, were evaluated during the initial assessment and the final assessment one year later. The DQ change index (%) was calculated as 100% X (final DQ-initial DQ)/initial DQ.

RESULTS

The DQs of all developmental domains in the non-ambulatory group were lower than those in the ambulatory group on both initial and final assessments (p<0.01). As indicated by the DQ change indices, most DQs in the ambulatory group decreased slightly, whereas those in the non-ambulatory group decreased considerably (p<0.05). Furthermore, fine motor function increased proportionally with age in the ambulatory group, but not in the non-ambulatory group.

CONCLUSION

The DQs of the developmental profiles varied in preschool CP children with different ambulatory abilities. The course of developmental profiles in preschool children with SQ CP evolves with age and relates to the degree of ambulatory function. Knowledge of these developmental profiles may be helpful in understanding, predicting, and managing the developmental problems of these children.

摘要

背景

探讨不同行走能力的痉挛型四肢瘫脑瘫(CP)学龄前儿童发育状况的随访过程。

方法

48名1至5岁的痉挛型四肢瘫脑瘫儿童在初次评估时根据粗大运动功能分类系统(GMFCS)水平分为两组,即行走组和非行走组。在初次评估和一年后的最终评估中,对包括8个领域发育商(DQ)的发育状况进行评估。DQ变化指数(%)计算为100%×(最终DQ - 初始DQ)/初始DQ。

结果

在初次和最终评估中,非行走组所有发育领域的DQ均低于行走组(p<0.01)。从DQ变化指数来看,行走组的大多数DQ略有下降,而非行走组的DQ大幅下降(p<0.05)。此外,行走组的精细运动功能随年龄成比例增加,而非行走组则不然。

结论

不同行走能力的学龄前脑瘫儿童发育状况的DQ各不相同。痉挛型四肢瘫脑瘫学龄前儿童的发育状况过程随年龄发展,并与行走功能程度相关。了解这些发育状况可能有助于理解、预测和管理这些儿童的发育问题。

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