title: Longitudinal changes in mobility following single-event multilevel surgery in ambulatory children with cerebral palsy.
abstract: OBJECTIVE
  To examine changes in mobility longitudinally following single-event multilevel surgery in ambulant children with cerebral palsy, focusing on those using assistive devices for functional mobility because they are most at risk of declining gross motor function.
  
  
  METHODS
  A consecutive sample of 156 ambulant children with cerebral palsy (99 males), 96 without devices (Gross Motor Function Classification System (GMFCS) I/II), 60 with devices (GMFCS III) who had single-event multilevel surgery at mean age 11 years 1 month.
  
  
  METHODS
  GMFCS and Functional Mobility Scale (FMS) ratings were recorded pre-operatively and at 2 and 5 years post-operatively. A proportional odds logistic regression model was used for the GMFCS III group to predict the probability of assistive device requirements post-operatively conditional on baseline FMS.
  
  
  RESULTS
  Children in GMFCS III showed more change than those in I/II at home and school. Those in GMFCS III using crutches pre-operatively at home and school were more likely to continue using them at 5 years, whereas those using walkers were more likely to change to crutches or wheelchairs. Wheelchairs were most commonly used in the community before and after single-event multilevel surgery.
  
  
  CONCLUSIONS
  Mobility was generally stable or improved at 5 years after single-event multilevel surgery; however, a small number of children used more assistance to facilitate mobility.
authors.affiliation: Murdoch Children's Research Institute, Hamilton, Canada and Murdoch Children’s Research Institute, Melbourne, Victoria, Australia. harvey.adrienne@gmail.com
authors.forename: Adrienne
authors.initials: A
authors.lastname: Harvey
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenbaum
authors.forename: Steven
authors.initials: S
authors.lastname: Hanna
authors.forename: Reza
authors.initials: R
authors.lastname: Yousefi-Nooraie
authors.forename: Kerr H
authors.initials: KH
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery; D002648:Child; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D012656:Self-Help Devices; D012720:Severity of Illness Index; D013990:Tidal Volume; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*