Keeratisiroj Orawan, Thawinchai Nuanlaor, Buntragulpoontawee Montana, Siritaratiwat Wantana
J Med Assoc Thai. 2016 Dec;99(12):1298-305.
Most parents want to know that their children with cerebral palsy will be able to walk. A simple tool to predict ambulatory status and one uses The Gross Motor Function Classification System is still lacking.
To develop a simple prognostic score chart for predicting ambulatory status in Thai children with cerebral palsy.
Four hundred seventy one children with cerebral palsy aged 2 to 18 registered and treated at six special schools or hospitals for children with physical disability between 2008 and 2013 were recruited. Baseline characteristics and clinical histories of children with cerebral palsy were collected from medical and physical therapy records. Ambulatory status was classified as three ordinal scales by The Gross Motor Function Classification System - Expanded and Revised version.
Multivariable ordinal continuation ratio logistic regression analysis identified age, type of cerebral palsy, sitting independently at the age of two, and eating independently as significant predictors of ambulation. These items were combined into a clinical prediction score: non-ambulation (scores <7), assisted ambulation (scores 7 to 8), and independent ambulation (scores >8).
The prognostic tool has high discriminative values of ambulatory status among children with cerebral palsy. However, the validation of this tool needs to be tested in other subjects before clinical practice application.
大多数脑瘫患儿的家长都想知道自己的孩子是否能够行走。目前仍缺乏一种使用粗大运动功能分类系统来预测行走状态的简单工具。
开发一种简单的预后评分表，用于预测泰国脑瘫患儿的行走状态。
招募了2008年至2013年间在六所特殊学校或肢体残疾儿童医院登记并接受治疗的471名2至18岁的脑瘫患儿。从医疗和物理治疗记录中收集脑瘫患儿的基线特征和临床病史。根据粗大运动功能分类系统扩展和修订版，将行走状态分为三个等级量表。
多变量有序连续比率逻辑回归分析确定年龄、脑瘫类型、两岁时独立坐立以及独立进食是行走的重要预测因素。这些项目被组合成一个临床预测评分：不能行走（评分<7）、辅助行走（评分7至8）和独立行走（评分>8）。
该预后工具在脑瘫患儿行走状态方面具有较高的判别价值。然而，在临床实践应用之前，需要在其他受试者中对该工具进行验证测试。
