Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, India; International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada.
International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada.
Res Dev Disabil. 2024 Nov;154:104829. doi: 10.1016/j.ridd.2024.104829. Epub 2024 Sep 24.
Developmental trajectories are crucial for evidence-based prognostication, planning interventions, and monitoring progress in children with cerebral palsy (CP).
To describe gross motor development patterns of children with CP in rural South India for the five Gross Motor Function Classification System (GMFCS) levels.
Longitudinal cohort study of 302 children (176 males, 126 females) with CP aged 0 to 10 years, followed by a community-based early intervention program. GMFCS levels were 5.4 % level 1, 16.5 % level II, 22.8 % level III, 26.8 % level IV, and 28.5 % level V. Assessments were undertaken using the Gross Motor Function Measure (GMFM-66) at 6-month intervals between April 2017 and August 2020. Longitudinal analyses were performed using mixed-effects linear regression models.
Five distinct motor development curves were created for ages 0 to 10 years by GMFCS levels as a function of age and GMFM-66 with a stable limit model, variation in estimated limits and rates of development.
Motor development trajectories for CP in an LMIC differ from those reported in HICs. Consideration of how social determinants of health, environmental and personal factors impact motor development in low-resource contexts is crucial. Further work is needed to describe developmental trajectories of children for CP in LMICs.
发展轨迹对于基于证据的预后预测、干预计划制定以及脑瘫（CP）儿童的进展监测至关重要。
描述印度农村地区 CP 儿童在五个粗大运动功能分类系统（GMFCS）水平下的粗大运动发育模式。
这是一项对 302 名年龄在 0 至 10 岁之间的 CP 儿童进行的纵向队列研究，这些儿童在社区中接受早期干预计划。GMFCS 级别为 5.4%为 1 级，16.5%为 2 级，22.8%为 3 级，26.8%为 4 级，28.5%为 5 级。使用粗大运动功能测量（GMFM-66）在 2017 年 4 月至 2020 年 8 月期间每 6 个月进行评估。使用混合效应线性回归模型进行纵向分析。
通过 GMFCS 级别作为年龄和 GMFM-66 的函数，为 0 至 10 岁的年龄创建了 5 个不同的运动发育曲线，具有稳定的限制模型、估计限制和发展速度的变化。
在中低收入国家（LMIC）中，CP 的运动发育轨迹与高收入国家（HIC）中报告的轨迹不同。考虑健康的社会决定因素、环境和个人因素如何影响低资源环境中的运动发育至关重要。还需要进一步的工作来描述 LMIC 中 CP 儿童的发育轨迹。
