Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
Dev Med Child Neurol. 2022 May;64(5):578-585. doi: 10.1111/dmcn.15112. Epub 2021 Nov 20.
To describe development of gross motor capacity and mobility performance in children with cerebral palsy.
This longitudinal cohort study measured gross motor capacity with the Gross Motor Function Measure and mobility performance with the Pediatric Evaluation of Disability Inventory (PEDI) between 18 months and 5 years, and the PEDI - Computer Adaptive Test (PEDI-CAT) between 8 years and 12 years. Longitudinal analyses used mixed-effects regression modelling with interaction between age and Gross Motor Function Classification System (GMFCS). Stability of GMFCS levels over time was measured using agreement.
Two hundred and twenty-two children provided 871 observations (median 4 observations, range 1-7). Children classified in GMFCS level I improved in both capacity and performance until 8 to 12 years. Children classified in GMFCS levels II and III continued to develop mobility performance after gross motor capacity had plateaued at 5 years. Children classified in GMFCS level IV plateaued at 5 years in capacity and performance. Children classified in GMFCS level V showed no changes in capacity or performance between 18 months and 8 to 12 years. Stability of GMFCS levels was 73%.
Change in mobility performance over time somewhat reflected gross motor capacity trajectories. Continued improvement in mobility performance after plateau of gross motor capacity for children classified in GMFCS levels II and III suggests importance of other personal or environmental factors.
描述脑瘫儿童粗大运动能力和移动性能的发展情况。
本纵向队列研究在 18 个月至 5 岁之间使用粗大运动功能测量（GMFM）测量粗大运动能力，使用残疾儿童评估量表（PEDI）测量移动性能，在 8 至 12 岁之间使用 PEDI-计算机自适应测试（PEDI-CAT）测量移动性能。纵向分析使用混合效应回归模型，并结合年龄和粗大运动功能分类系统（GMFCS）之间的交互作用。使用一致性来测量 GMFCS 水平随时间的稳定性。
222 名儿童提供了 871 次观察（中位数为 4 次，范围为 1-7 次）。在 8 至 12 岁时，被分类为 GMFCS 水平 I 的儿童在能力和表现方面都有所提高。在 5 岁时，GMFCS 水平 II 和 III 的儿童的粗大运动能力达到平台期后，其移动性能仍在继续发展。在 5 岁时，被分类为 GMFCS 水平 IV 的儿童在能力和表现方面都达到了平台期。在 18 个月至 8 至 12 岁之间，被分类为 GMFCS 水平 V 的儿童在能力和表现方面都没有变化。GMFCS 水平的稳定性为 73%。
随时间推移移动性能的变化在一定程度上反映了粗大运动能力的轨迹。对于被分类为 GMFCS 水平 II 和 III 的儿童，在粗大运动能力达到平台期后，移动性能仍继续提高，这表明其他个人或环境因素的重要性。
