Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania, USA.
CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, CA, USA.
Phys Occup Ther Pediatr. 2020;40(1):62-78. doi: 10.1080/01942638.2019.1642288. Epub 2019 Jul 18.
To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP). Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) levels were determined by consensus between parents and therapists. Parents' completed the Performance in Self-Care domain of the Child Engagement in Daily Life Measure two to five times at 6-month intervals. Nonlinear mixed-effects models were used to create longitudinal trajectories. Quantile regression was used to construct cross-sectional reference percentiles. The trajectories for children in levels I, II, and III are characterized by an average maximum score between 79.6 (level I) and 62.8 (level III) and an average attainment of 90% of the maximum score between 7 and 9 years of age. The trajectories for children in level IV and V show minimal change over time. Extreme variation in performance among children of the same age and GMFCS level complicate interpretation of percentile change of individual children. The findings are useful for monitoring self-care of children with CP and evaluating change for children in GMFCS levels I-III.
为了创建脑瘫（CP）儿童自我护理表现的纵向轨迹和参考百分位数。参与者为 708 名 CP 儿童，年龄在 18 个月至 11 岁之间，其父母居住在加拿大和美国的 10 个地区。总体运动功能分类系统（GMFCS）水平由父母和治疗师之间的共识确定。父母在六个月的间隔内完成儿童参与日常生活测量的自我护理领域的表现，完成了两到五次。使用非线性混合效应模型创建纵向轨迹。使用分位数回归构建横截面参考百分位数。I、II 和 III 级儿童的轨迹以 79.6（I 级）和 62.8（III 级）之间的平均最高得分和 7 至 9 岁之间平均达到最高得分的 90%为特征。IV 级和 V 级儿童的轨迹随时间变化极小。相同年龄和 GMFCS 水平的儿童之间表现的极端差异使个别儿童的百分位变化的解释复杂化。这些发现对于监测 CP 儿童的自我护理和评估 GMFCS 水平 I-III 儿童的变化很有用。
