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Relationship between gross motor capacity and daily‐life mobility in children with cerebral palsy
Authors:DIRK‐WOUTER SMITS  JAN WILLEM GORTER  MARJOLIJN KETELAAR  PETRA EM VAN SCHIE  ANNET J DALLMEIJER  ELINE LINDEMAN  MARIAN J JONGMANS
Institution:1. Centre of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Centre De Hoogstraat, Utrecht, the Netherlands.;2. Department of Rehabilitation and Sports Medicine, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, the Netherlands.;3. NetChild, Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands.;4. NetChild, Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands.;5. CanChild, Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.;6. Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, the Netherlands.;7. Institute for Research in Extramural Medicine (EMGO Institute), Amsterdam, the Netherlands.;8. Department of Special Education, Utrecht University, Utrecht, the Netherlands.;9. Department of Paediatric Psychology, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, Utrecht, the Netherlands.
Abstract:Aim The aim of this study was to examine the relationship between gross motor capacity and daily‐life mobility in children with cerebral palsy (CP) and to explore the moderation of this relationship by the severity of CP. Method Cross‐sectional analysis in a cohort study with a clinic‐based sample of children with CP (n=116; 76 males, 40 females; mean age 6y 3mo, SD 12mo, range 4y 8mo–7y 7mo) was performed. Gross motor capacity was assessed by the Gross Motor Function Measure (GMFM‐66). Daily‐life mobility was assessed using the Pediatric Evaluation of Disability Inventory (PEDI): Functional Skills Scale (FSS mobility) and Caregiver Assistance Scale (CAS mobility). Severity of CP was classified by the Gross Motor Function Classification System (48% level I, 17% level II, 15% level III, 8% level IV, 12% level V), type of motor impairment (85% spastic, 12% dyskinetic, 3% ataxic), and limb distribution (36% unilateral, 49% bilateral spastic). Results Scores on the GMFM‐66 explained 90% and 84% respectively, of the variance of scores on PEDI‐FSS mobility and PEDI‐CAS mobility. Limb distribution moderated the relationship between scores on the GMFM‐66 and the PEDI‐FSS mobility, revealing a weaker relationship in children with unilateral spastic CP (24% explained variance) than in children with bilateral spastic CP (91% explained variance). Interpretation In children aged 4 to 7 years with unilateral spastic CP, dissociation between gross motor capacity and daily‐life mobility can be observed, just as in typically developing peers.
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