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- Title
Prognosis for gross motor function in cerebral palsy: creation of motor development curves.
- Authors
Rosenbaum PL; Walter SD; Hanna SE; Palisano RJ; Russell DJ; Raina P; Wood E; Bartlett DJ; Galuppi BE; Rosenbaum, Peter L; Walter, Stephen D; Hanna, Steven E; Palisano, Robert J; Russell, Dianne J; Raina, Parminder; Wood, Ellen; Bartlett, Doreen J; Galuppi, Barbara E
- Abstract
<bold>Context: </bold>Lack of a valid classification of severity of cerebral palsy and the absence of longitudinal data on which to base an opinion have made it difficult to consider prognostic issues accurately.<bold>Objective: </bold>To describe patterns of gross motor development of children with cerebral palsy by severity, using longitudinal observations, as a basis for prognostic counseling with parents and for planning clinical management.<bold>Design: </bold>Longitudinal cohort study of children with cerebral palsy, stratified by age and severity of motor function and observed serially for up to 4 years during the period from 1996 to 2001.<bold>Setting: </bold>Nineteen publicly funded regional children's ambulatory rehabilitation programs in Ontario.<bold>Participants: </bold>A total of 657 children aged 1 to 13 years at study onset, representing the full spectrum of clinical severity of motor impairment in children with cerebral palsy.<bold>Main Outcome Measures: </bold>Severity of cerebral palsy, classified with the 5-level Gross Motor Function Classification System; function, formally assessed with the Gross Motor Function Measure (GMFM).<bold>Results: </bold>Based on a total of 2632 GMFM assessments, 5 distinct motor development curves were created; these describe important and significant differences in the rates and limits of gross motor development among children with cerebral palsy by severity. There is substantial within-stratum variation in gross motor development.<bold>Conclusions: </bold>Evidence-based prognostication about gross motor progress in children with cerebral palsy is now possible, providing parents and clinicians with a means to plan interventions and to judge progress over time. Further work is needed to describe motor function of adolescents with cerebral palsy.
- Publication
JAMA: Journal of the American Medical Association, 2002, Vol 288, Issue 11, p1357
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.288.11.1357