Factors affecting mobility in the transition period from childhood to adolescence in cerebral palsy: A prospective longitudinal study.

OBJECTIVE

To investigate changes in mobility and factors affecting mobility over a 2-year period from childhood to adolescence in children with cerebral palsy.

DESIGN AND

SETTING

A multi-site, prospective, longitudinal, cohort study was carried out. Data were collected in a single one-hour session at school or at home at baseline, and again one year and two years later.

PARTICIPANTS

Seventy-five children with cerebral palsy aged 10.8 years (SD 1.1) at baseline participated. Participants were classified within Level I (33%), Level II (35%), Level III (12%) and Level IV (20%) of the Gross Motor Function Classification System (GMFCS).

METHODS

Five impairments (loss of sensation, loss of strength, incoordination, spasticity and contracture) and three aspects of mobility (5-Times-Sit-To-Stand Test, 10-m Walk Test and 6-min Walk Test) were measured. All measurements were collected by one physiotherapist with 15 years of experience. Stepwise multiple regression analysis was conducted to examine the relationship between change in sensory and motor impairments with change in mobility.

RESULTS

Overall, mobility, as well as coordination and strength increased, while spasticity, contracture, and sensation remained the same over the two years. In terms of the 6-min Walk Test, approximately 74% of participants improved, while 11% did not change and 15% deteriorated. Change in strength and coordination accounted for 20% of the variance in change in the 6-min Walk Test.

CONCLUSIONS

Mobility increased over the two years of pre-adolescence and this was accompanied by an increase in muscle strength and coordination. CONTRIBUTION OF PAPER.