Functional outcome following stroke in children.
The aim of this study was to describe the functional consequences of childhood stroke in terms of activity limitation and to explore the relationship between extent of brain damage, impairment, and functional sequelae. A further aim was to describe the health of the parents of these children. Seventeen children and adolescents with cerebral infarction in the territory of the middle cerebral artery were enrolled in the study. A new activity limitation measure with a 4-point Likert scale (the Paediatric Stroke Activity Limitation Measure) was designed to examine the degree of difficulty experienced by the children in daily activities. The relationship between activity limitation scores, standardized health-related quality of life assessment (Child Health Questionnaire), extent of brain damage, and results of a comprehensive neurologic examination (Pediatric Stroke Outcome Measure) were investigated. Parent health was assessed using the Short-Form 36 General Health Survey. Activity limitation was evident in the domains of education, self-care, and motor skills. There was very good interobserver agreement using the new activity limitation scale between the occupational therapist and pediatric neurologist (Cohen's kappa = 0.88). In comparison with population norms, the subjects scored below average in both physical and psychologic health. There was a clear relationship between radiologically apparent extent of brain damage, degree of impairment, and functional outcome. Parental health also rated generally lower than expected. This exploratory study suggests that both children who have had a stroke and their parents have significant and wide-ranging health needs.
Gordon
Anne L
AL
Great Ormond Street Hospital for Children NHS Trust, London, England. gordonanne@yahoo.co.uk
Ganesan
Vijeya
V
Towell
Anthony
A
Kirkham
Fenella J
FJ
D000203:Activities of Daily Living; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D020244:Infarction, Middle Cerebral Artery / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008603:Mental Health; D009048:Motor Skills; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000523:psychology; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires