Article

The aim of this study was to use a prospective longitudinal study to
describe age-related trends in energy efficiency during gait, activity, and
participation in ambulatory children with cerebral palsy (CP). METHOD: Gross
Motor Function Measure (GMFM), Paediatric Evaluation of Disability Inventory
(PEDI), and Lifestyle Assessment Questionnaire-Cerebral Palsy (LAQ-CP) scores,
and energy efficiency (oxygen cost) during gait were assessed in representative
sample of 184 children (112 male; 72 female; mean age 10y 9mo; range 4-16y) with
CP. Ninety-four children had unilateral spastic CP, 84 bilateral spastic CP, and
six had other forms of CP. Fifty-seven were classified as Gross Motor Function
Classification System (GMFCS) level I, 91 as level II, 22 as level III, and 14 as
level IV). Assessments were carried out on two occasions (visit 1 and visit 2)
separated by an interval of 2 years and 7 months. A total of 157 participants
returned for reassessment. RESULTS: Significant improvements in mean raw scores
for GMFM, PEDI, and LAQ-CP were recorded; however, mean raw oxygen cost
deteriorated over time. Age-related trends revealed gait to be most inefficient
at the age of 12 years, but GMFM scores continued to improve until the age of 13
years, and two PEDI subscales to age 14 years, before deteriorating (p<0.05).
Baseline score was consistently the single greatest predictor of visit 2 score.
Substantial agreement in GMFCS ratings over time was achieved (kappa(lw)
=0.74-0.76). INTERPRETATION: These findings have implications in terms of optimal
provision and delivery of services for young people with CP to maximize physical
capabilities and maintain functional skills into adulthood.
CI - (c) The Authors. Journal compilation (c) Mac Keith Press 2010.

Langue : ANGLAIS