de Leeuw Marleen J, Schasfoort Fabienne C, Spek Bea, van der Ham Inez, Verschure Stella, Westendorp Tessa, Pangalila Robert F
Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.
Department of General Practice, Intellectual Disability Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Heliyon. 2021 Dec 4;7(12):e08537. doi: 10.1016/j.heliyon.2021.e08537. eCollection 2021 Dec.
Assessing prognosis of self-care and mobility capabilities in children with cerebral palsy (CP) is important for goal setting, treatment guidance and meaningful professional-caregiver conversations.
Identifying factors associated with changes in self-care and mobility capabilities in regular outpatient multidisciplinary paediatric CP rehabilitation care.
Routinely monitored longitudinal data, assessed with the Paediatric Evaluation of Disability Inventory (PEDI-Functional-Skills-Scale, FSS 0-100) was retrospectively analysed. We determined contributions of age, gross-motor function, bimanual-arm function, intellectual function, education type, epilepsy, visual function, and psychiatric comorbidity to self-care and mobility capability changes (linear-mixed-models).
For 90 children (53 boys), in all Gross-Motor-Function-Classification-System (GMFCS) levels, 272 PEDI's were completed. Mean PEDI-FSS-scores at first measurement (median age: 3,2 years) for self-care and mobility were 46.3 and 42.4, and mean final FSS-scores respectively were 55.1 and 53.1 (median age: 6,5 years). Self-care capability change was significantly associated with age (2.81, p < 0.001), GMFCS levels III-V (-9.12 to -46.66, p < 0.01), and intellectual impairment (-6.39, p < 0.01). Mobility capability change was significantly associated with age (3.25, p < 0.001) and GMFCS levels II-V (-6.58 to -47.12, p < 0.01).
Most important prognostic factor for self-care and mobility capabilities is GMFCS level, plus intellectual impairment for self-care. Maximum capability levels are reached at different ages, which is important for individual goal setting and managing expectations.
评估脑瘫（CP）患儿的自我护理和运动能力预后对于目标设定、治疗指导以及专业护理人员与家长之间有意义的沟通非常重要。
确定在常规门诊多学科儿科CP康复护理中与自我护理和运动能力变化相关的因素。
回顾性分析通过儿童残疾评估量表（PEDI-功能技能量表，FSS 0-100）进行常规监测的纵向数据。我们确定了年龄、粗大运动功能、双手臂功能、智力功能、教育类型、癫痫、视觉功能和精神合并症对自我护理和运动能力变化的影响（线性混合模型）。
对于90名儿童（53名男孩），在所有粗大运动功能分类系统（GMFCS）水平中，共完成了272次PEDI评估。首次测量时（中位年龄：3.2岁）自我护理和运动能力的平均PEDI-FSS分数分别为46.3和42.4，最终平均FSS分数分别为55.1和53.1（中位年龄：6.5岁）。自我护理能力变化与年龄（2.81，p<0.001）、GMFCS III-V级（-9.12至-46.66，p<0.01）和智力障碍（-6.39，p<0.01）显著相关。运动能力变化与年龄（3.25，p<0.001）和GMFCS II-V级（-6.58至-47.12，p<0.01）显著相关。
自我护理和运动能力最重要的预后因素是GMFCS水平，自我护理还包括智力障碍。在不同年龄达到最大能力水平，这对于个体目标设定和管理期望很重要。
