Osteogenesis imperfecta: profiles of motor development as assessed by a postal questionnaire.
This study was performed to achieve more detailed information regarding the age and sequence in the development of motor milestones in the different types of osteogenesis imperfecta (OI). The parents of 98 patients with a diagnosis of OI were sent a questionnaire regarding the age at which patients achieved motor milestones. All patients were attending the outpatient clinic for children with OI at the Wilhelmina Children's Hospital. The motor milestones were classified into static motor milestones and dynamic motor milestones and all data were checked with health care records. The age of development of motor milestones was compared to reference values of the healthy population. The severity of the disease was classified according to Sillence based on clinical, genetic and radiological data. The age of intramedullary rodding of the first nail in the lower and upper extremity and the localisation was noted. A total of 76 parents responded to the 98 questionnaires (78%). In OI type I, a delay exists in achieving motor milestones, comparable to the 95th percentile of the normal population. In type III, the development of all motor milestones was significantly delayed compared to types I and IV with a discrepancy between static and dynamic milestones. In OI type IV, a retardation in motor development developed after the milestone 'sitting without support' was achieved. Motor development in types I and IV was not influenced by intramedullary rodding of the lower extremities, since rodding was rarely performed before the milestone 'unsupported standing' was achieved. In type III, the influence of intramedullary rodding on the age of achieving motor milestones remains questionable.


CONCLUSIONS
The severity of osteogenesis imperfecta has a large influence on the age and sequence in the development of motor milestones. No influence of intramedullary rodding of the lower extremities on motor development was found in osteogenesis imperfecta types I and IV, whereas the influence in type III remains questionable.
Engelbert
R H
RH
Department of Paediatric Physical Therapy, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands. R.Engelbert@wkz.azu.nl
Uiterwaal
C S
CS
Gulmans
V A
VA
Pruijs
H E
HE
Helders
P J
PJ
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008297:Male; D009048:Motor Skills; D010013:Osteogenesis Imperfecta / Q000145:classification / Q000150:complications* / Q000601:surgery; D012016:Reference Values; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016474:Weight-Bearing