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J Pediatr. 2014 Apr;164(4):769-774.e2. doi: 10.1016/j.jpeds.2013.11.070. Epub 2014 Jan 10.

Developmental trajectories of mobility and self-care capabilities in young children with cerebral palsy.

Author information

1
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands. Electronic address: M.Ketelaar@dehoogstraat.nl.
2
Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.
3
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
4
CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
5
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands.

Abstract

OBJECTIVE:

To describe development of mobility and self-care capabilities in young children (aged 1-4 years) with cerebral palsy, and to examine whether the development of mobility and self-care capabilities differs by cerebral palsy severity in terms of 5 distinct Gross Motor Function Classification System (GMFCS) levels.

STUDY DESIGN:

This prospective longitudinal cohort study included 100 children with cerebral palsy (aged 1.5 or 2.5 years at baseline) and their parents. Mobility and self-care capabilities were assessed by the Pediatric Evaluation of Disability Inventory during yearly assessments from inclusion up to age 4.5 years. Longitudinal data for 92 children were available for analysis. Repeated-measures analyses with random coefficient analysis were performed using linear mixed models.

RESULTS:

Despite large variations among individuals in the development of mobility and self-care capabilities in young children with cerebral palsy, distinct developmental trajectories were found for children in different GMFCS levels. The estimated change per month differed significantly by GMFCS level for both outcomes.

CONCLUSIONS:

This longitudinal study provides an evidence base for prognosis in daily mobility and self-care skills in young children with cerebral palsy. The developmental trajectories for GMFCS levels can be helpful in communication between professionals and also in discussions of expectations and goal setting with families regarding mobility and self-care in the daily life of young children with cerebral palsy in neonatal follow-up and pediatric practice.

PMID:
24418472
DOI:
10.1016/j.jpeds.2013.11.070
[Indexed for MEDLINE]

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