Longitudinal changes in mobility following single-event multilevel surgery in ambulatory children with cerebral palsy.
Longitudinal changes in mobility following single-event multilevel surgery in ambulatory children with cerebral palsy.
复制标题
脑瘫门诊儿童单次多层次手术后活动能力的纵向变化。
DOI：
10.2340/16501977-0916
复制
发表时间：
2012
影响因子：
3.5
通讯作者：
K. Graham
中科院分区：
文献类型：
--
作者：
A. Harvey;P. Rosenbaum;S. Hanna;R. Yousefi;K. Graham
客观化
目的：研究脑性瘫痪患儿单事件多节段手术后纵向活动能力的变化，重点关注那些使用辅助设备进行功能活动的儿童，因为他们最有可能出现粗大运动功能下降。
参与者
随机抽样调查脑性瘫痪患儿156例(男性99例)，其中96例未植入装置(粗大运动功能分级系统I/II)，60例植入装置(GMFCS III)，平均年龄11岁1个月。
方法
分别于术前、术后2年和5年记录术前GMFCS和功能活动量表(FMS)评分。对于GMFCS III组，使用比例优势Logistic回归模型来预测在基线FMS的基础上术后需要辅助装置的概率。
结果
GMFCS III组儿童在家庭和学校表现出比I/II组儿童更多的变化。在GMFCS III组中，那些在家中和学校手术前使用拐杖的人在5年后更有可能继续使用拐杖，而那些使用助行器的人更有可能改用拐杖或轮椅。轮椅在单事件多节段手术前后最常在社区使用。
结论
在单事件多节段手术后5年，活动能力总体稳定或改善；然而，少数儿童使用更多的辅助来促进活动能力。
OBJECTIVE
To examine changes in mobility longitudinally following single-event multilevel surgery in ambulant children with cerebral palsy, focusing on those using assistive devices for functional mobility because they are most at risk of declining gross motor function.
PARTICIPANTS
A consecutive sample of 156 ambulant children with cerebral palsy (99 males), 96 without devices (Gross Motor Function Classification System (GMFCS) I/II), 60 with devices (GMFCS III) who had single-event multilevel surgery at mean age 11 years 1 month.
METHODS
GMFCS and Functional Mobility Scale (FMS) ratings were recorded pre-operatively and at 2 and 5 years post-operatively. A proportional odds logistic regression model was used for the GMFCS III group to predict the probability of assistive device requirements post-operatively conditional on baseline FMS.
RESULTS
Children in GMFCS III showed more change than those in I/II at home and school. Those in GMFCS III using crutches pre-operatively at home and school were more likely to continue using them at 5 years, whereas those using walkers were more likely to change to crutches or wheelchairs. Wheelchairs were most commonly used in the community before and after single-event multilevel surgery.
CONCLUSION
Mobility was generally stable or improved at 5 years after single-event multilevel surgery; however, a small number of children used more assistance to facilitate mobility.
影响因子：
3.8
作者：
Palisano, RJ;Cameron, D;Russell, D
通讯作者：
Russell, D