Journal article
Determinants of gross motor function of young children with cerebral palsy: a prospective cohort study
Developmental medicine and child neurology, v 56(3)
Mar 2014
PMID: 24127787
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Aim
The aim of this study was to test a model of determinants of gross motor function of young children with cerebral palsy (CP).
Method
Four hundred and twenty‐nine children with CP (242 males, 187 females; mean age 3y 2mo, SD 11mo) representing all levels of the Gross Motor Function Classification System (GMFCS) participated. Children in levels I to II and III to V were classified as Groups 1 and 2 respectively. Distribution of CP was quadriplegia, 44%; hemiplegia, 24%; diplegia, 23%; triplegia, 6%; and monoplegia, 2% (data not available for 1%). Impairment and motor function data were collected by reliable assessors; parents completed questionnaires on health conditions and adaptive behavior. Seven months later, parents were interviewed about family life and services received. One year after the study onset, motor function was re‐evaluated. Analysis involved structural equation modeling.
Results
The well‐fitting model explained 58% and 75% of the variance in motor function at study completion for Groups 1 and 2 respectively. Primary impairments (spasticity, quality of movement, postural stability, and distribution of involvement; β=0.52–0.68) and secondary impairments (strength, range of motion limitations, and reduced endurance; β=0.25–0.26) explained the most variance. Adaptive behavior was a significant determinant only for Group 2 (β=0.21) and participation in community programs was significant only in Group 1 (β=0.13).
Interpretation
Motor function is supported by optimizing body structures and function for all children and enhancing adaptive behavior for children with greater motor challenges.
What this paper adds
A higher proportion of gross motor function is explained for children in GMFCS levels III to V compared with children in levels I to II.
Both primary and secondary impairments are significant determinants of gross motor function among children with CP.
Adaptive behavior is a significant determinant of gross motor function for children in GMFCS levels III to V.
Determinants amenable to change (postural stability, strength, and adaptive behavior) are reasonable areas for intervention.
Metrics
Details
- Title
- Determinants of gross motor function of young children with cerebral palsy: a prospective cohort study
- Creators
- Doreen J Bartlett - Western UniversityLisa A Chiarello - Drexel UniversitySarah W Mccoy - University of WashingtonRobert J Palisano - Drexel UniversityLynn Jeffries - The University of Oklahoma Health Sciences CentreAlyssa L Fiss - Mercer UniversityPeter Rosenbaum - McMaster UniversityPiotr Wilk - Western University
- Publication Details
- Developmental medicine and child neurology, v 56(3)
- Publisher
- Wiley
- Number of pages
- 8
- Grant note
- Canadian Institutes of Health Research (MOP 81107) US Department of Education National Institute for Disability and Rehabilitation Research (H133G060254)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]; Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:000330854400014
- Scopus ID
- 2-s2.0-84893731409
- Other Identifier
- 991014878635604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Pediatrics