Early motor repertoire is related to level of self-mobility in children with cerebral palsy at school age.
OBJECTIVE
To determine the predictive value of the early motor repertoire for the level of self-mobility in children with cerebral palsy (CP) at school age.


METHODS
Video recordings were made at 11 to 17 weeks post-term of 37 preterm infants (20 males, 17 females) who later developed CP. The early motor repertoire was assessed by obtaining a motor optimality score. At 6 to 12 years, children were classified according to the Gross Motor Function Classification System (GMFCS).


RESULTS
Of 37 children (mean gestational age 29.1wks, SD 1.9; mean birthweight 1273g, SD 324), nine had unilateral and 28 had bilateral spastic CP. Twelve children were in GMFCS level I, three level II, 10 level III, four level IV, and eight level V. The absence of the age-adequate motor repertoire, a cramped motor repertoire, an abnormal kicking pattern, and a non-flat supine posture were associated with lower levels of self-mobility (chi(2) for trend test, p<0.05). Predictive for a low level of self-mobility was a cramped motor repertoire/non-flat supine posture (positive predictive values [PPV] 100%, negative predictive values [NPV] 54%). Predictive for a high level of self-mobility was a non-cramped repertoire/flat supine posture (PPV 80%, NPV 74%).


CONCLUSIONS
Several aspects of the motor repertoire at 11 to 17 weeks post-term predicted the degree of functional limitations in children with CP at school age.
Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. j.l.m.bruggink@bkk.umcg.nl
Janneke Lm
JL
Bruggink
Giovanni
G
Cioni
Christa
C
Einspieler
Carel Gb
CG
Maathuis
Rosa
R
Pascale
Arend F
AF
Bos
D000367:Age Factors; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology*; D002648:Child; D002657:Child Development / Q000502:physiology*; D051341:Dependent Ambulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011187:Posture / Q000502:physiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors