Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands.
Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.
J Pediatr. 2014 Apr;164(4):769-774.e2. doi: 10.1016/j.jpeds.2013.11.070. Epub 2014 Jan 10.
To describe development of mobility and self-care capabilities in young children (aged 1-4 years) with cerebral palsy, and to examine whether the development of mobility and self-care capabilities differs by cerebral palsy severity in terms of 5 distinct Gross Motor Function Classification System (GMFCS) levels.
This prospective longitudinal cohort study included 100 children with cerebral palsy (aged 1.5 or 2.5 years at baseline) and their parents. Mobility and self-care capabilities were assessed by the Pediatric Evaluation of Disability Inventory during yearly assessments from inclusion up to age 4.5 years. Longitudinal data for 92 children were available for analysis. Repeated-measures analyses with random coefficient analysis were performed using linear mixed models.
Despite large variations among individuals in the development of mobility and self-care capabilities in young children with cerebral palsy, distinct developmental trajectories were found for children in different GMFCS levels. The estimated change per month differed significantly by GMFCS level for both outcomes.
This longitudinal study provides an evidence base for prognosis in daily mobility and self-care skills in young children with cerebral palsy. The developmental trajectories for GMFCS levels can be helpful in communication between professionals and also in discussions of expectations and goal setting with families regarding mobility and self-care in the daily life of young children with cerebral palsy in neonatal follow-up and pediatric practice.
描述脑瘫幼儿(1-4 岁)运动和自理能力的发展情况,并探讨运动和自理能力的发展是否因脑瘫严重程度的不同而存在差异,表现为 5 种不同的粗大运动功能分类系统(GMFCS)水平。
这是一项前瞻性纵向队列研究,纳入了 100 名脑瘫儿童(基线时为 1.5 或 2.5 岁)及其家长。在从纳入到 4.5 岁的每年评估中,使用儿童残疾评估量表(PEDI)评估运动和自理能力。92 名儿童的纵向数据可用于分析。采用线性混合模型的随机系数分析进行重复测量分析。
尽管脑瘫幼儿运动和自理能力的发展在个体之间存在很大差异,但在不同 GMFCS 水平的儿童中发现了明显的发展轨迹。对于这两个结果,每个月的估计变化在 GMFCS 水平上差异显著。
这项纵向研究为脑瘫幼儿日常移动和自理技能的预后提供了证据基础。GMFCS 水平的发展轨迹有助于专业人员之间的沟通,也有助于在新生儿随访和儿科实践中与家长讨论脑瘫幼儿日常生活中移动和自理的期望和目标设定。