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Prognosis for gross motor function in cerebral palsy: creation of motor development curves

Peter L Rosenbaum1, Stephen D Walter, Steven E Hanna

  • 1Department of Pediatrics, School of Rehabilitation Science, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada, L8S 1C7. rosenbau@mcmaster.ca

JAMA
|September 18, 2002
PubMed

Insights

This study establishes evidence-based gross motor development curves for children with cerebral palsy (CP) by severity. These curves aid in prognostic counseling and clinical management planning for improved outcomes.

Area of Science:

  • Pediatric Rehabilitation
  • Neurology
  • Developmental Pediatrics

Background:

  • Accurate prognostic assessment for cerebral palsy (CP) has been hindered by a lack of validated severity classifications and longitudinal data.
  • Difficulty in predicting long-term outcomes impacts clinical management and parental counseling for children with CP.

Purpose of the Study:

  • To delineate gross motor development patterns in children with CP, categorized by severity, using longitudinal data.
  • To provide a foundation for prognostic counseling and informed clinical management strategies for pediatric CP.

Main Methods:

  • A longitudinal cohort study involving 657 children with CP (aged 1-13 years) across 19 rehabilitation centers in Ontario.
  • Children were stratified by age and motor function severity, using the 5-level Gross Motor Function Classification System (GMFCS).
  • Gross motor function was assessed serially using the Gross Motor Function Measure (GMFM) over a 4-year period (1996-2001).

Main Results:

  • Five distinct motor development curves were generated from 2632 GMFM assessments, revealing significant differences in development rates and limits based on CP severity.
  • The study identified substantial variation in gross motor development within each severity stratum.
  • These curves offer a quantitative basis for understanding developmental trajectories in pediatric CP.

Conclusions:

  • Evidence-based prognostication for gross motor progress in children with CP is now feasible, empowering parents and clinicians.
  • The developed curves facilitate intervention planning and progress monitoring over time.
  • Further research is recommended to characterize the motor function of adolescents with CP.
Abstract

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