Bult M K, Verschuren O, Lindeman E, Jongmans M J, Westers P, Claassen A, Ketelaar M
Rudolph Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center de Hoogstraat, Utrecht, the Netherlands.
Child Care Health Dev. 2013 May;39(3):374-80. doi: 10.1111/j.1365-2214.2012.01391.x. Epub 2012 Jun 8.
This longitudinal study aims to determine which child, family and environmental variables measured at 2 years of age predict leisure participation in formal and informal activities in school aged children with cerebral palsy (CP).
Parents of 46 children with CP (mean age at baseline: 2 years 6 months, SD 0 years 1 month; at follow-up 6 years 7 months, SD 0 years 9 months; n = 26 boys, n = 20 girls; Gross Motor Classification System I = 30%, II = 7%, III = 28%, IV = 24%, V = 11%) completed the Children's Assessment of Participation and Enjoyment indicating their child's participation. Multivariate regression models were used to identify early predictors of participation.
Movement ability was a significant child-related predictor for formal activities (R(2) 17%, P < 0.05). Movement ability and social skills were most predictive (R(2) 62%, P < 0.00) for informal activities. The feeling of being restricted in family participation was the single most predictive factor for formal and informal activities at family level (R(2) 12%, P < 0.05, R(2) 25%, P < 0.05). Type of daycare was the only environmental variable that was predictive, and only for informal activities (R(2) 16%, P < 0.05). In the overall model movement ability was most predictive for leisure participation in formal activities (R(2) 17%, P < 0.05). Movement ability and social skills are the most important predictors for informal leisure participation (R(2) 62%, P < 0.01).
Several variables are found to be related to formal and informal participation at age 6. Movement ability and social skills at age 2 are most predictive of leisure participation when the child is 6 years old.
本纵向研究旨在确定2岁时测量的哪些儿童、家庭和环境变量可预测学龄期脑瘫(CP)儿童参与正式和非正式活动的情况。
46名脑瘫儿童的家长(基线平均年龄:2岁6个月,标准差0岁1个月;随访时6岁7个月,标准差0岁9个月;n = 26名男孩,n = 20名女孩;粗大运动功能分类系统I = 30%,II = 7%,III = 28%,IV = 24%,V = 11%)完成了儿童参与和享受情况评估,表明其孩子的参与情况。使用多元回归模型确定参与的早期预测因素。
运动能力是正式活动中与儿童相关的重要预测因素(R(2) 17%,P < 0.05)。运动能力和社交技能对非正式活动的预测性最强(R(2) 62%,P < 0.00)。在家庭层面,家庭参与受限感是正式和非正式活动的唯一最重要预测因素(R(2) 12%,P < 0.05,R(2) 25%,P < 0.05)。日托类型是唯一具有预测性的环境变量,且仅对非正式活动有预测性(R(2) 16%,P < 0.05)。在总体模型中,运动能力对正式活动中休闲参与的预测性最强(R(2) 17%,P < 0.05)。运动能力和社交技能是非正式休闲参与的最重要预测因素(R(2) 62%,P < 0.01)。
发现几个变量与6岁时的正式和非正式参与有关。2岁时的运动能力和社交技能对孩子6岁时的休闲参与预测性最强。