Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
Habiliteringscenter Haninge, Habilitation & Health, Region Stockholm, Sweden.
Phys Occup Ther Pediatr. 2021;41(2):138-149. doi: 10.1080/01942638.2020.1830915. Epub 2020 Oct 13.
To determine the degree of stability in the Gross Motor Function Classification System (GMFCS) for children with cerebral pares (CP) and to analyze factors associated with changes of the over time, in Stockholm between the year 2000 and 2019.
A register study on 768 children with at least two GMFCS ratings, linear regression analysis was used to study factors associated to a change in GMFCS level.
72% of the children kept the same GMFCS level. A change in GMFCS level was most common for children in GMFCS level II (68%). The first change in GMFCS level happened most commonly between the ages 2 and 4. Initial GMFCS level (Beta 0.127; p < 0.001) and one or more intensive training periods with a physiotherapist (Beta 0.097; p = 0.018) were associated with a change in GMFCS level.
Most children with CP remain stable in their GMFCS level, but for those classified in level II, a change occurs for almost seven out of ten. Classifications made before the child turns four are less certain than those made later. Further studies are needed to clarify if occurrence of intensive training is the cause or result of the change in GMFCS level.
确定脑瘫儿童粗大运动功能分级系统（GMFCS）的稳定性程度，并分析 2000 年至 2019 年斯德哥尔摩 GMFCS 级别随时间变化的相关因素。
这是一项针对至少接受过两次 GMFCS 评估的 768 名儿童的登记研究，使用线性回归分析来研究与 GMFCS 水平变化相关的因素。
72%的儿童保持相同的 GMFCS 水平。GMFCS 水平变化最常见于 GMFCS 水平 II 的儿童（68%）。GMFCS 水平的首次变化最常见于 2 至 4 岁之间。初始 GMFCS 水平（Beta 0.127；p<0.001）和一次或多次与物理治疗师的密集训练期（Beta 0.097；p=0.018）与 GMFCS 水平的变化相关。
大多数脑瘫儿童的 GMFCS 水平保持稳定，但对于分类为 II 级的儿童，近十分之七的儿童会发生变化。在儿童四岁之前进行的分类不如之后的分类确定。需要进一步研究以明确密集训练的发生是否是 GMFCS 水平变化的原因或结果。
