Multidimensional outcome assessment in cerebral palsy: is it feasible and relevant?
BACKGROUND
To examine feasibility and relevance of a multidimensional outcome assessment approach using instrumented 3-dimensional gait analysis, via the Gillette Gait Index (GGI), and a set of validated functional and health-related quality of life tools in diplegic cerebral palsy children, before introduction as a nationwide evaluation set.


METHODS
A 3-year prospective government-funded multicenter study was conducted, recruiting patients during a 9-month period classified using the Gross Motor Function Classification System and the Rodda et al sagittal walking patterns. The Gross Motor Classification System Dimensions D and E, the 10-level Gillette Functional Assessment Questionnaire, the Energy Expenditure Index (EEI), the GGI out of 3D gait analysis, and health-related quality of life, assessed by self or proxy with the questionnaire "Vècu et Santè Perçu de l'Adolescent," were selected for the study.


RESULTS
Cross-sectional data subset at inclusion of 160 spastic diplegic cerebral palsy patients, the largest series in our country, 6 to 18 years old (mean age, 11.0 years), are reported. The GGI correlated significantly (P < 0.001) with the Gross Motor Classification System, the Functional Assessment Questionnaire, and the EEI for all the patients, and all but one (EEI) correlated if grouped according to Gross Motor Function Classification System or Rodda. No systematic correlation was found between the quality of life scores and the other outcome tools.


CONCLUSIONS
The outcome evaluation instrument set tested in our study helps to adopt common tools, to be integrated in an evidence-based practice and to compare health status and treatment outcome between countries, specifically in different linguistic environments like in European countries.
Viehweger
Elke
E
Department of Pediatric Orthopaedics, Children's Hospital Timone, 264 Rue Saint Pierre, Marseille Cedex 05, France. elke.viehweger@mail.ap-hm.fr
Haumont
Thierry
T
de Lattre
Capucine
C
Presedo
Ana
A
Filipetti
Paul
P
Ilharreborde
Brice
B
Lebarbier
Pierre
P
Loundou
Anderson
A
Simeoni
Marie-Claude
MC
D000293:Adolescent; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005240:Feasibility Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011446:Prospective Studies