title: Longitudinal changes in health-related quality of life in preschool children with cerebral palsy of different levels of motor severity.
abstract: BACKGROUND
  When setting goals for cerebral palsy (CP) interventions, health-related quality of life (HRQoL) is an important outcome.
  
  
  OBJECTIVE
  To compare longitudinal changes in HRQoL in children with CP of different levels of motor severity.
  
  
  METHODS
  Seventy-three children with CP were collected and classified into three groups based on Gross Motor Function Classification System (GMFCS) levels. HRQoL was assessed by parent's proxy of the TNO-AZL Preschool Quality of Life (TAPQOL) at baseline and 6 months later.
  
  
  RESULTS
  Children with GMFCS level V had a lower total TAPQOL score and scores in all domains than those with level I-IV (p<0.01), except for the non-motor subdomain of physical functioning at follow-up. With regards to longitudinal changes, the children with GMFCS level V had greater improvements in physical (p=0.016) and cognitive functioning (p=0.042), but greater deterioration in emotional functioning (p=0.008) than those with levels I-II at 6 months of follow-up.
  
  
  CONCLUSIONS
  Motor severity was associated with TAPQOL scores in all domains and changes in some domains in children with CP. Clinicians should early identify children at risk of a poor HRQoL and plan timely treatment strategies to enhance the HRQoL of children with CP.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital and School of Medicine, No. 201, Sec.2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, Taiwan; National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, Taiwan 112, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: 1204milly@gmail.com.
authors.forename: Chih-Jou
authors.initials: CJ
authors.lastname: Lai
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taiwan. Electronic address: jongyau@adm.cgmh.org.tw.
authors.forename: Chung-Yao
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: clingchen@gmail.com.
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital-Linkuo, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: chanp@mail.cgu.edu.tw.
authors.forename: Pei-Ying Sarah
authors.initials: PS
authors.lastname: Chan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan; Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: shenih@mail.cgu.edu.tw.
authors.forename: I-Hsuan
authors.initials: IH
authors.lastname: Shen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan; Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: cywu@mail.cgu.edu.tw.
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Wu
mesh_terms: D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000523:psychology; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index
keywords: Cerebral palsy; Longitudinal study; Motor severity; Quality of life