Article

The aim of this study was to test a model of determinants of gross motor
function of young children with cerebral palsy (CP).
METHOD: Four hundred and
twenty-nine children with CP (242 males, 187 females; mean age 3 y 2 mo, SD 11
mo) representing all levels of the Gross Motor Function Classification System
(GMFCS) participated. Children in levels I to II and III to V were classified as
Groups 1 and 2 respectively. Distribution of CP was quadriplegia, 44%;
hemiplegia, 24%; diplegia, 23%; triplegia, 6%; and monoplegia, 2% (data not
available for 1%). Impairment and motor function data were collected by reliable
assessors; parents completed questionnaires on health conditions and adaptive
behavior. Seven months later, parents were interviewed about family life and
services received. One year after the study onset, motor function was
re-evaluated. Analysis involved structural equation modeling. RESULTS: The
well-fitting model explained 58% and 75% of the variance in motor function at
study completion for Groups 1 and 2 respectively. Primary impairments
(spasticity, quality of movement, postural stability, and distribution of
involvement; beta=0.52-0.68) and secondary impairments (strength, range of motion
limitations, and reduced endurance; beta=0.25-0.26) explained the most variance.
Adaptive behavior was a significant determinant only for Group 2 (beta=0.21) and
participation in community programs was significant only in Group 1 (beta=0.13).
INTERPRETATION: Motor function is supported by optimizing body structures and
function for all children and enhancing adaptive behavior for children with
greater motor challenges.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS