Prospective longitudinal study of gross motor function in children with cerebral palsy.
OBJECTIVE
To describe the course of gross motor function over 2 years in children with cerebral palsy (CP) aged 9 to 15 years, and to investigate its relationship with impairments and age.


METHODS
Prospective cohort study.


METHODS
Rehabilitation department of a university medical center in the Netherlands.


METHODS
Seventy boys and 40 girls with CP (mean age +/- standard deviation, 11.2+/-1.7y).


METHODS
Not applicable.


METHODS
The Gross Motor Function Measure (GMFM).


RESULTS
GMFM item scores were stable over the 2 years for the whole group. No difference was found in the course of GMFM item scores between the Gross Motor Function Classification System (GMFCS) levels. We found significant differences in the course of GMFM item scores (corrected for GMFCS) for the different levels of limb distribution, selective motor control, muscle strength, range of motion in the hip and knee, spasticity of the hamstrings, and type of education. There were significantly larger decreases in the more severely affected children. Multivariable analysis showed that a poor selective motor control was the most important determinant of a less favorable course of gross motor function.


CONCLUSIONS
Some impairment characteristics may be used to identify children who are at risk for deterioration in gross motor function, and may serve as a guide for interventions.
Voorman
Jeanine M
JM
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. reva@vumc.nl
Dallmeijer
Annet J
AJ
Knol
Dirk L
DL
Lankhorst
Gustaaf J
GJ
Becher
Jules G
JG
D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D004519:Education, Special; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D019957:Motor Skills Disorders / Q000503:physiopathology*; D009128:Muscle Spasticity / Q000503:physiopathology; D053580:Muscle Strength / Q000502:physiology; D009426:Netherlands; D011446:Prospective Studies; D011782:Quadriplegia / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index