Article

OBJECTIVE: To determine the amount of variability in scores on activity and
participation measures used to assess ambulatory individuals with cerebral palsy
explained by strength, body composition, gait impairment and participant
characteristics. DESIGN: Multicentre prospective cross-sectional study. SETTING:
Seven paediatric-orthopaedic specialty hospitals. PARTICIPANTS:
Three hundred and
seventy-seven ambulatory individuals (241 males, 136 females) with cerebral
palsy, Gross Motor Function Classification System (GMFCS) levels I-III (I = 148,
II = 153, III = 76), ages 8-18 years (mean 12 years 9 months, SD 2 years 8
months). METHODS: Participants completed assessments of GMFCS level, patient
history, lower extremity muscle strength, Gross Motor Function Measure (GMFM-66),
Pediatric Outcomes Data Collection Instrument (PODCI), instrumented gait
analysis, 1 minute walk test, Timed Up-and-Go and body composition. Multiple
linear regression and bootstrap analyses were performed for each outcome measure,
stratified by GMFCS level. RESULTS: The amount of variability in outcome measures
explained by participant characteristics, strength, and gait impairment ranged
from 11% to 50%. Gait impairment was the most common predictor variable and
frequently explained the greatest variance across all outcome measures and GMFCS
levels. As gait impairment increased, scores on outcome measures decreased.
Strength findings were inconsistent and not a primary factor. Body composition
contributed minimally (<4%) in explaining variability. Participant
characteristics (cerebral palsy type, gestational age and age at walking onset),
were significant predictor variables in several models. CONCLUSIONS: Variability
in outcome measure scores is multifaceted and only partially explained by
strength and gait impairment illustrating the challenges of attempting to explain
variation within this heterogeneous population. Clinicians treating individuals
with cerebral palsy should consider this when developing treatment paradigms.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS