title: Australian Cerebral Palsy Child Study: protocol of a prospective population based study of motor and brain development of preschool aged children with cerebral palsy.
abstract: BACKGROUND
  Cerebral palsy (CP) results from a static brain lesion during pregnancy or early life and remains the most common cause of physical disability in children (1 in 500). While the brain lesion is static, the physical manifestations and medical issues may progress resulting in altered motor patterns. To date, there are no prospective longitudinal studies of CP that follow a birth cohort to track early gross and fine motor development and use Magnetic Resonance Imaging (MRI) to determine the anatomical pattern and likely timing of the brain lesion. Existing studies do not consider treatment costs and outcomes. This study aims to determine the pathway(s) to motor outcome from diagnosis at 18 months corrected age (c.a.) to outcome at 5 years in relation to the nature of the brain lesion (using structural MRI).
  
  
  METHODS
  This prospective cohort study aims to recruit a total of 240 children diagnosed with CP born in Victoria (birth years 2004 and 2005) and Queensland (birth years 2006-2009). Children can enter the study at any time between 18 months to 5 years of age and will be assessed at 18, 24, 30, 36, 48 and 60 months c.a. Outcomes include gross motor function (GMFM-66 & GMFM-88), Gross Motor Function Classification System (GMFCS); musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function (Manual Ability Classification System), communication difficulties using Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP), participation using the Paediatric Evaluation of Disability Inventory (PEDI), parent reported quality of life and classification of medical and allied health resource use and determination of the aetiology of CP using clinical evaluation combined with MRI. The relationship between the pathways to motor outcome and the nature of the brain lesion will be analysed using multiple methods including non-linear modelling, multilevel mixed-effects models and generalised estimating equations.
  
  
  CONCLUSIONS
  This protocol describes a large population-based study of early motor development and brain structure in a representative sample of preschool aged children with CP, using direct clinical assessment. The results of this study will be published in peer reviewed journals and presented at relevant international conferences.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Register (ACTRN1261200169820).
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Health Sciences, The University of Queensland, Brisbane, Australia. r.boyd@uq.edu.au
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.forename: Rachel
authors.initials: R
authors.lastname: Jordan
authors.forename: Laura
authors.initials: L
authors.lastname: Pareezer
authors.forename: Anne
authors.initials: A
authors.lastname: Moodie
authors.forename: Christine
authors.initials: C
authors.lastname: Finn
authors.forename: Belinda
authors.initials: B
authors.lastname: Luther
authors.forename: Evyn
authors.initials: E
authors.lastname: Arnfield
authors.forename: Aaron
authors.initials: A
authors.lastname: Pym
authors.forename: Alex
authors.initials: A
authors.lastname: Craven
authors.forename: Paula
authors.initials: P
authors.lastname: Beall
authors.forename: Kelly
authors.initials: K
authors.lastname: Weir
authors.forename: Megan
authors.initials: M
authors.lastname: Kentish
authors.forename: Meredith
authors.initials: M
authors.lastname: Wynter
authors.forename: Robert
authors.initials: R
authors.lastname: Ware
authors.forename: Michael
authors.initials: M
authors.lastname: Fahey
authors.forename: Barry
authors.initials: B
authors.lastname: Rawicki
authors.forename: Lynne
authors.initials: L
authors.lastname: McKinlay
authors.forename: Andrea
authors.initials: A
authors.lastname: Guzzetta
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D001315:Australia; D001921:Brain / Q000254:growth & development / Q000473:pathology*; D002547:Cerebral Palsy / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D002675:Child, Preschool; D015331:Cohort Studies; D003142:Communication; D018672:Community Health Planning; D002658:Developmental Disabilities / Q000209:etiology*; D004185:Disability Evaluation; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D005684:Gait; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity; D009048:Motor Skills / Q000502:physiology*; D009069:Movement Disorders / Q000209:etiology*; D041641:Musculoskeletal Development; D012189:Retrospective Studies