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Published on: December 5, 2014
Motor functions in non-ambulatory children with spastic diplegia and periventricular leukomalacia
1Department of Rehabilitation, Ohzora Hospital, 7448 Nakagawa, Hosoe, Inasa, 431-1304, Shizuoka, Japan. yokochi@orange.ne.jp
Insights
Children with spastic diplegia and periventricular leukomalacia show delayed gross motor skill acquisition. Lower locomotive ability correlates with poorer hand function, mental ability, and increased joint contractures.
Area of Science:
- Pediatrics
- Neurology
- Developmental Pediatrics
Background:
- Spastic diplegia and periventricular leukomalacia significantly impact motor development in children.
- Understanding the trajectory of gross motor skill acquisition is crucial for early intervention.
Purpose of the Study:
- To investigate the acquisition patterns of gross motor skills in non-ambulatory children with spastic diplegia and periventricular leukomalacia.
- To explore the relationship between locomotive ability, hand function, mental ability, and joint contractures.
Main Methods:
- Longitudinal study of 20 non-ambulatory children diagnosed with spastic diplegia and periventricular leukomalacia.
- Assessment of gross motor skills (rolling, creeping, sitting, walking with support), hand function, mental ability, and joint contractures.
- Age of acquisition for key motor milestones was recorded.
Main Results:
- All participants could roll by 24 months; creeping was achieved by 18-30 months.
- Severe locomotive disability was associated with delayed sitting, poorer hand and mental function, and hip/knee contractures.
- Mild disability was linked to ankle contractures in some cases.
Conclusions:
- Gross motor skill acquisition is significantly delayed and variable in children with spastic diplegia and periventricular leukomalacia.
- Severity of motor impairment influences developmental milestones, cognitive function, and physical complications.
- Early assessment and targeted interventions are vital for optimizing outcomes.
Abstract:
The course of acquisition of various gross motor skills and changes in their patterns with advancing age, in addition to joint contracture, hand function, and mental ability, were investigated in 20 non-ambulatory children with spastic diplegia and periventricular leukomalacia. Among the diplegic children studied, those with lower locomotive ability also had lower hand function, lower mental ability and slower acquisition of gross motor skills. All subjects could roll by 24 months of age. Fourteen patients could creep by 18 months of age, and the remaining six by 30 months. Crawling was observed in only five patients with mild locomotive disability as a final locomotive pattern on the floor. Among ten patients with mild locomotive disability, three could sit by 2 years of age, six by 3 years, and one by 4 years. Among ten patients with severe disability, two, two, four and two children could sit at the ages of 2, 3, 4 and 5 years, respectively. Twelve patients could walk with support at between 2 and 5 years of age. Delay in acquisition of creeping or sitting differed somewhat among subjects with similar final locomotive disability. The majority of subjects with severe locomotive disability developed contracture of the hips and knees. Only two patients with mild disability had contracture of the ankles.
