Reference centiles for the gross motor function measure and identification of therapeutic effects in children with cerebral palsy. 2019

Ibrahim Duran, and Christina Stark, and Kyriakos Martakis, and Stefanie Hamacher, and Oliver Semler, and Eckhard Schoenau
Center of Prevention and Rehabilitation, UniReha, University of Cologne, Cologne, Germany.

OBJECTIVE Children with cerebral palsy (CP) can show an increase in gross motor function until the age of 9 to 10 years under the standard of care. Additionally, the motor development can have large individual fluctuations. Therefore, in clinical setting, it is not trivial to estimate the effect of an additional therapeutic intervention at this age interval. The study aim was to develop a method which allows quantification of the gross motor function changes over 6 months of the individual child with CP. METHODS The present study was a single center retrospective analysis. Data were collected in children with CP who participated in a rehabilitation program between 2006 and 2016. The gross motor function of the children was measured with the Gross Motor Function Measurement (GMFM-66). Reference centiles for the GMFM-66 were created with data before starting the rehabilitation program. The variability of the evolution of the GMFM-66 was assessed with data at the start and the end of a 6-month observational phase of standard of care. RESULTS In total, the GMFM-66 data of 919 children before starting the rehabilitation program were available (age 6.49 ± 2.49 years, GMFCS-level I-V). For 515 study participants (6.76 ± 2.30 years, GMFCS-level I-V), data were also available at the start and the end of a 6-month observational phase. CONCLUSIONS The presented method helps to guide the clinician to track the individual patient's gross motor development and assess the additional effect of an additionally applied intervention while taking into account the expected progression of gross motor function under standard of care.

UI MeSH Term Description Entries
D008297 Male Males
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D009048 Motor Skills Performance of complex motor acts. Motor Skill,Skill, Motor,Skills, Motor
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002657 Child Development The continuous sequential physiological and psychological maturing of an individual from birth up to but not including ADOLESCENCE. Infant Development,Development, Child,Development, Infant
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004185 Disability Evaluation Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. Disability Evaluations,Evaluation, Disability,Evaluations, Disability
D005260 Female Females
D005858 Germany A country in central Europe, bordering the Baltic Sea and the North Sea, between the Netherlands and Poland, south of Denmark. The capital is Berlin.

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