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Age‐related changes in energy efficiency of gait, activity, and participation in children with cerebral palsy
Author(s) -
KERR CLAIRE,
MCDOWELL BRONA C,
PARKES JACKIE,
STEVENSON MIKE,
COSGROVE AIDAN P
Publication year - 2011
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2010.03795.x
Subject(s) - cerebral palsy , gross motor function classification system , raw score , gait , physical therapy , ambulatory , spastic , gross motor skill , psychology , medicine , physical medicine and rehabilitation , motor skill , developmental psychology , surgery , raw data , statistics , mathematics
Aim 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 (κ 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.