Merhy Kemle Caroline, de Oliveira Marina Fischer, Bella Geruza Perlato, Maurer-Morelli Claudia Vianna
Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Department of Physiotherapy and Occupational Therapy, University Hospital, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Pediatric Health Med Ther. 2025 Mar 1;16:47-59. doi: 10.2147/PHMT.S500983. eCollection 2025.
Cerebral Palsy (CP) is caused by multiple risk factors bringing motor and postural control disruptions with a variety of clinical signs.
To describe the epidemiological and functional profile of children with CP attended at the Physiotherapy Clinic for Motor Rehabilitation (PCMR) of the Clinical Hospital (CH) of the University of Campinas (Unicamp).
Children up to 12 years old with CP were included. Epidemiological data were collected through interviews, followed by the scales: Gross Motor Function Classification System (GMFCS), Pediatric Evaluation of Disability Inventory (PEDI), Gross Motor Function Measure (GMFM-66), International Classification of Functioning, Disability, and Health for Children and Youth with CP (ICF-CY-CP) Core Sets, and the GMFCS Family Report Questionnaire.
A total of 37 children were assessed, with an average age of 7 years. It was found that 87% of the mothers received prenatal care, 61% of the children were born at a low weight, with 36% of cases being extreme or very premature births. The primary perinatal complication was neonatal anoxia (50%), while the most common postnatal complication was stroke (11%). CP was diagnosed at an average age of 12 months, with bilateral spastic CP being the most prevalent (63%). Orthopedic complications were present in 80% of cases, even though only 39% of children had orthopedic monitoring. In the functional analysis, 65% were classified at levels IV and V of the GMFCS, highly correlated with GMFCS Family Report Questionnaire (Kappa = 0.88; 95% IC 0.79-0.96). The scores of 3 and 4 on the ICF-CY-CP Core Sets in most activities involving motor functions, along with scores below 30 on the PEDI, indicate severe motor impairment.
Parents had a realistic perception of the children's functionality. The results highlight the severity of motor impairment in these children and emphasize the need for multidisciplinary assistance.
脑瘫(CP)由多种风险因素引起,会导致运动和姿势控制障碍,并伴有多种临床症状。
描述在坎皮纳斯大学(UNICAMP)临床医院(CH)的运动康复物理治疗诊所(PCMR)就诊的脑瘫患儿的流行病学和功能概况。
纳入12岁及以下的脑瘫患儿。通过访谈收集流行病学数据,随后使用以下量表:粗大运动功能分类系统(GMFCS)、儿童残疾评定量表(PEDI)、粗大运动功能测量(GMFM - 66)、脑瘫儿童和青少年功能、残疾与健康国际分类(ICF - CY - CP)核心集以及GMFCS家庭报告问卷。
共评估了37名儿童,平均年龄为7岁。发现87%的母亲接受了产前护理,61%的儿童出生时体重低,其中36%为极早产或早产。主要围产期并发症是新生儿缺氧(50%),而最常见的产后并发症是中风(11%)。脑瘫平均在12个月时被诊断出来,双侧痉挛性脑瘫最为普遍(63%)。80%的病例存在骨科并发症,尽管只有39%的儿童接受了骨科监测。在功能分析中,65%被归类为GMFCS的IV级和V级,与GMFCS家庭报告问卷高度相关(Kappa = 0.88;95%可信区间0.79 - 0.96)。在大多数涉及运动功能的活动中,ICF - CY - CP核心集的得分在3分和4分,以及PEDI得分低于30分,表明存在严重的运动障碍。
家长对孩子的功能有现实的认知。结果突出了这些儿童运动障碍的严重性,并强调了多学科援助的必要性。