Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years
Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years
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DOI：
10.1111/j.1469-8749.2008.03196.x
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发表时间：
2009-04-01
影响因子：
3.8
通讯作者：
Russell, Dianne J.
中科院分区：
文献类型：
--
作者：
Hanna, Steven E.;Rosenbaum, Peter L.;Russell, Dianne J.
本文报告了脑瘫（CP）儿童和青少年粗大运动发育曲线的构建，以评估青春期期间功能是否丧失。我们对之前参加前瞻性纵向队列研究的儿童进行了另外 4 年的跟踪研究，当时他们正进入青春期和成年早期。由此产生的纵向数据集包含 657 名 CP 儿童（369 名男性，288 名女性）的 3455 次观察，评估最多 10 次，年龄范围从 16 个月到 21 岁。使用 66 项粗大运动功能测量 (GMFM-66) 评估运动功能。使用粗大运动功能分类系统（GMFCS）对参与者进行分类。我们通过将假设没有损失的功能模型与允许峰值和随后下降的模型进行对比来评估青春期的功能损失。我们没有发现 GMFCS I 级和 II 级儿童的平均功能下降的证据。然而，在 III、IV 和 V 级中，平均 GMFM-66 估计分别在 7 岁 11 个月、6 岁 11 个月和 6 岁 11 个月时达到峰值，然后随着这些青少年成为青年人，在 III、IV 和 V 级中分别下降 4.7、7.8 和 6.4 GMFM-66 点。我们证明这些下降具有临床意义。
This paper reports the construction of gross motor development curves for children and youth with cerebral palsy (CP) in order to assess whether function is lost during adolescence. We followed children previously enrolled in a prospective longitudinal cohort study for an additional 4 years, as they entered adolescence and young adulthood. The resulting longitudinal dataset comprised 3455 observations of 657 children with CP (369 males, 288 females), assessed up to 10 times, at ages ranging from 16 months to 21 years. Motor function was assessed using the 66-item Gross Motor Function Measure (GMFM-66). Participants were classified using the Gross Motor Function Classification System (GMFCS). We assessed the loss of function in adolescence by contrasting a model of function that assumes no loss with a model that allows for a peak and subsequent decline. We found no evidence of functional decline, on average, for children in GMFCS Levels I and II. However, in Levels III, IV, and V, average GMFM-66 was estimated to peak at ages 7 years 11 months, 6 years 11 months, and 6 years 11 months respectively, before declining by 4.7, 7.8, and 6.4 GMFM-66 points, in Levels III, IV, and V respectively, as these adolescents became young adults. We show that these declines are clinically significant.