Prospective Longitudinal Study of Gross Motor Function in Children With Cerebral Palsy
Abstract
Voorman JM, Dallmeijer AJ, Knol DL, Lankhorst GJ, Becher JG. Prospective longitudinal study of gross motor function in children with cerebral palsy.
Objectives
To describe the course of gross motor function over 2 years in children with cerebral palsy (CP) aged 9 to 15 years, and to investigate its relationship with impairments and age.
Design
Prospective cohort study.
Setting
Rehabilitation department of a university medical center in the Netherlands.
Participants
Seventy boys and 40 girls with CP (mean age ± standard deviation, 11.2±1.7y).
Interventions
Not applicable.
Main Outcome Measure
The Gross Motor Function Measure (GMFM).
Results
GMFM item scores were stable over the 2 years for the whole group. No difference was found in the course of GMFM item scores between the Gross Motor Function Classification System (GMFCS) levels. We found significant differences in the course of GMFM item scores (corrected for GMFCS) for the different levels of limb distribution, selective motor control, muscle strength, range of motion in the hip and knee, spasticity of the hamstrings, and type of education. There were significantly larger decreases in the more severely affected children. Multivariable analysis showed that a poor selective motor control was the most important determinant of a less favorable course of gross motor function.
Conclusions
Some impairment characteristics may be used to identify children who are at risk for deterioration in gross motor function, and may serve as a guide for interventions.
aDepartment of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
bEMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
cDepartment of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
Reprint requests to Jeanine M. Voorman, MD, Dept of Rehabilitation Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
Supported by the Netherlands Organisation for Health Research and Development (grant no. 1435.0011).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT