Prognosis or gross motor function in cerebral palsy - Creation of motor development curves
Prognosis or gross motor function in cerebral palsy - Creation of motor development curves
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DOI：
10.1001/jama.288.11.1357
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发表时间：
2002-09-18
影响因子：
120.7
通讯作者：
Galuppi, BE
中科院分区：
文献类型：
--
作者：
Rosenbaum, PL;Walter, SD;Galuppi, BE
背景缺乏一个有效的分类的严重性脑瘫和缺乏纵向数据的基础上，一个意见，使它很难考虑准确的预后issues.Objective描述模式的粗大运动发育的严重性脑瘫儿童，使用纵向观察，作为与父母进行预后咨询和规划临床管理的基础。设计脑性瘫痪儿童的纵向队列研究，根据年龄和运动功能的严重程度分层，并在1996年至2001年期间连续观察长达4年。设置安大略的19个公共资助的地区儿童门诊康复计划。参与者在研究开始时，主要指标脑瘫严重程度，用5级粗大运动功能分类系统分类;结果根据2632份GMFM评定结果，建立了5条不同的运动发育曲线;这些描述了严重程度不同的脑性瘫痪儿童在粗大运动发育的速度和限制方面的重要和显著差异。有大量的层内变异粗大运动development.Conclusions脑瘫儿童粗大运动的进展循证acreticulation现在是可能的，提供家长和临床医生的手段来规划干预措施，并判断随着时间的推移进展。需要进一步的工作来描述脑瘫青少年的运动功能。
Context Lack of a valid classification of severity of cerebral palsy and the absence of longitudinal data on which to base an opinion have made it difficult to consider prognostic issues accurately.Objective To describe patterns of gross motor development of children with cerebral palsy by severity, using longitudinal observations, as a basis for prognostic counseling with parents and for planning clinical management.Design Longitudinal cohort study of children with cerebral palsy, stratified by age and severity of motor function and observed serially for up to 4 years during the period from 1996 to 2001.Setting Nineteen publicly funded regional children's ambulatory rehabilitation programs in Ontario.Participants A total of 657 children aged 1 to 13 years at study onset, representing the full spectrum of clinical severity of motor impairment in children with cerebral palsy.Main Outcome Measures Severity of cerebral palsy, classified with the 5-level Gross Motor Function Classification System; function, formally assessed with the Gross Motor Function Measure (GMFM).Results Based on a total of 2632 GMFM assessments, 5 distinct motor development curves were created; these describe important and significant differences in the rates and limits of gross motor development among children with cerebral palsy by severity. There is substantial within-stratum variation in gross motor development.Conclusions Evidence-based prognostication about gross motor progress in children with cerebral palsy is now possible, providing parents and clinicians with a means to plan interventions and to judge progress over time. Further work is needed to describe motor function of adolescents with cerebral palsy.