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Gross motor function of children with down syndrome: Creation of motor growth curves

  • Robert J. Palisano
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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  • Stephen D. Walter
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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  • Dianne J. Russell
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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  • Peter L. Rosenbaum
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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  • Maryan Gémus
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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  • Barbara E. Galuppi
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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  • Larry Cunningham
    Affiliations
    Department of Rehabilitation Sciences, MCP Hahnemann University (Palisano), Philadelphia, PA; and Department of Clinical Epidemiology and Biostatistics (Walter), CanChild Centre for Childhood Disability Research (Palisano, Walter, Russell, Rosenbaum, Gémus, Galuppi, Cunningham), McMaster University, Hamilton, Ont
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      Abstract

      Palisano RJ, Walter SD, Russell DJ, Rosenbaum PL, Gémus M, Galuppi BE, Cunningham L. Gross motor function of children with Down syndrome: creation of motor growth curves. Arch Phys Med Rehabil 2001;82:494-500. Objective: To create gross motor function growth curves for children with Down syndrome (DS) and to estimate the probability that motor functions are achieved by different ages. Design: Nonlinear growth curve analysis by using a 2-parameter (rate, upper limit) model. Setting: Early intervention programs, schools, and children's homes. Participants: One hundred twenty-one children with DS, ages 1 month to 6 years. Main Outcome Measures: Gross Motor Function Measure (GMFM) and severity of motor impairment. Results: The curves for children with mild (n = 51) and moderate/severe (n = 70) impairment were characterized by a greater increase in GMFM scores during infancy and smaller increases as the children approached the predicted maximum score of 85.9 or 87.9. The estimated probability that a child would roll by 6 months was 51%; sit by 12 months, 78%; crawl by 18 months, 34%; walk by 24 months, 40%; and run, walk up stairs, and jump by 5 years, 45% to 52%. Conclusions: Children with DS require more time to learn movements as movement complexity increases. Impairment severity affected the rate but not the upper limit of motor function. The results have implications for counseling parents, making decisions about motor interventions, and anticipating the time frame for achievement of motor functions. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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