Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
Dev Med Child Neurol. 2021 May;63(5):584-591. doi: 10.1111/dmcn.14763. Epub 2020 Dec 24.
To explore relationships between category classifications for children's rehabilitation goals, outcomes, and participant characteristics.
Children with hemiparetic cerebral palsy due to perinatal stroke rated self-selected goals with the Canadian Occupational Performance Measure (COPM) and completed the Assisting Hand Assessment (AHA) and Box and Block Test (BBT), at baseline and 6 months, in a randomized, controlled 10-day neuromodulation rehabilitation trial using repetitive transcranial magnetic stimulation. Goals were classified with the Canadian Model of Occupational Performance and Engagement and the International Classification of Functioning, Disability and Health. Analysis included standard linear regression.
Data for 45 participants (mean age 11y 7mo, SD 3y 10mo, range 6-19y, 29 males, 16 females) on 186 goals were included. Self-care goal percentage corresponded with baseline BBT by age (standardized ß=-0.561, p=0.004). Leisure goal percentage corresponded with baseline BBT (standardized ß=0.419, p=0.010). AHA change corresponded with productivity goals (standardized ß=0.327, p=0.029) and age (standardized ß=0.481, p=0.002). COPM change corresponded with baseline COPM and age by AHA change (p<0.05).
Younger children with lower motor function were more likely to select self-care goals while those with better function tended to select leisure goals. Functional improvement corresponded with older age and productivity goals. COPM change scores reflected functional improvement among older children. Children chose functionally and developmentally appropriate goals. Consequently, children should be free to set goals that matter to them.
Children in a brain stimulation trial chose divergent upper extremity functional goals. Younger children with lower ability chose more self-care goals. Children with higher ability chose more leisure goals. Older children's goal ratings reflected objective functional motor gains. Children chose goals appropriate to their function and level of development.
探讨儿童康复目标、结果和参与者特征的类别分类之间的关系。
45 名因围产期卒中导致偏瘫脑瘫的儿童使用加拿大职业表现测量（COPM）自评目标，并在一项随机对照的为期 10 天的神经调节康复试验中使用重复经颅磁刺激完成了辅助手评估（AHA）和方块和积木测试（BBT），基线和 6 个月时进行。目标采用加拿大职业表现与参与模式和国际功能、残疾和健康分类进行分类。分析包括标准线性回归。
45 名参与者（平均年龄 11 岁 7 个月，标准差 3 岁 10 个月，范围 6-19 岁，29 名男性，16 名女性）的 186 个目标的数据被纳入研究。自我护理目标的百分比与基线 BBT 按年龄呈对应关系（标准化 ß=-0.561，p=0.004）。休闲目标的百分比与基线 BBT 呈对应关系（标准化 ß=0.419，p=0.010）。AHA 变化与生产力目标（标准化 ß=0.327，p=0.029）和年龄（标准化 ß=0.481，p=0.002）呈对应关系。COPM 变化与基线 COPM 和 AHA 变化时的年龄呈对应关系（p<0.05）。
运动功能较低的年幼儿童更有可能选择自我护理目标，而运动功能较好的儿童更倾向于选择休闲目标。功能改善与年龄较大和生产力目标相关。COPM 变化评分反映了大龄儿童的功能改善。儿童选择了与功能和发育相适应的目标。因此，儿童应该自由地选择对他们重要的目标。
大脑刺激试验中的儿童选择了不同的上肢功能目标。运动能力较低的年幼儿童选择了更多的自我护理目标。运动能力较高的儿童选择了更多的休闲目标。大龄儿童的目标评定反映了客观的运动功能改善。儿童选择了与他们的功能和发育水平相适应的目标。
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