Validation of a model of gross motor function for children with cerebral palsy
Validation of a model of gross motor function for children with cerebral palsy
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DOI：
10.1093/ptj/80.10.974
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发表时间：
2000-10-01
期刊：
影响因子：
3.2
通讯作者：
Galuppi, BE
中科院分区：
文献类型：
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作者：
Palisano, RJ;Hanna, SE;Galuppi, BE
背景和目的。脑瘫 (CP) 儿童粗大运动功能的发展尚未有记录。本研究的目的是检查 CP 儿童的粗大运动功能模型，并应用该模型为粗大运动功能分类系统 (GMFCS) 的 5 个级别中的每个级别构建粗大运动功能曲线。科目。分层样本包括 586 名 1 至 12 岁的 CP 儿童，他们居住在加拿大安大略省，并为康复中心所熟知。方法。使用 GMFCS 对受试者进行分类，并使用粗大运动功能测量 (GMFM) 来测量粗大运动功能。检查了四个模型来构建描述年龄和粗大运动功能之间非线性关系的曲线。结果。每个 GMFCS 级别的限制参数（最大 GMFM 分数）和速率参数（接近最大 GMFM 分数的速率）都不同的模型解释了 83% 的 GMFM 分数变化。 5 条曲线的预测最大 GMFM 分数不同（I 级 = 96.8、II 级 = 89.3、III 级 = 61.3、IV 级 = 36.1 和 V 级 = 12.9）。 II 级儿童达到 GMFM 最高分数的速度比 I 级和 III 级儿童的速度慢。 GMFCS 水平与 GMFM 分数之间的相关性为 -.91。逻辑回归用于根据 GMFM 总分估计 CP 儿童能够实现粗大运动里程碑的概率，表明 GMFCS 水平之间的差异具有临床意义。结论与讨论。根据功能能力和限制对脑瘫儿童进行分类可以预测粗大运动功能，而单独年龄的预测效果较差。通过与同龄和 GMFCS 水平的儿童进行比较来评估 CP 儿童的粗大运动功能，对于干预结果的决策和解释具有重要意义。
Background and Purpose. Development of gross motor function in children with cerebral palsy (CP) has not been documented. The purposes of this study were to examine a model of gross motor function in children with CP and to apply the model to construct gross motor function curves for each of the 5 levels of the Gross Motor Function Classification System (GMFCS). Subjects. A stratified sample of 586 children with CP, 1 to 12 years of age, who reside in Ontario, Canada, and are known to rehabilitation centers participated. Methods. Subjects were classified using the GMFCS, and gross motor function was measured with the Gross Motor Function Measure (GMFM). Four models were examined to construct curves that described the nonlinear relationship between age and gross motor function. Results. The model in which both the limit parameter (maximum GMFM score) and the rate parameter (rate at which the maximum GMFM score is approached) vary for each GMFCS level explained 83% of the variation in GMFM scores. The predicted maximum GMFM scores differed among the 5 curves (level I=96.8, level II=89.3, level III=61.3, level IV=36.1, and level V=12.9). The rate at which children at level II approached their maximum GMFM score was slower than the rates for levels I and III. The correlation between GMFCS levels and GMFM scores was -.91. Logistic regression, used to estimate the probability that children with CP are able to achieve gross motor milestones based on their GMFM total scores, suggests that distinctions between GMFCS levels are clinically meaningful. Conclusion and Discussion. Classification of children with CP based on functional abilities and limitations is predictive of gross motor function, whereas age alone is a poor predictor. Evaluation of gross motor function of children with CP by comparison with children of the same age and GMFCS level has implications for decision making and interpretation of intervention outcomes.