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[Factors involved in the prognosis of walking in cerebral paralysis]
1AACD, Associação de Assistência à Criança Defeituosa, São Paulo, Brasil.
Insights
Prognosis for walking in children with cerebral palsy (CP) is negatively impacted by severe motor dysfunction and delayed sitting balance. Severe intellectual disability combined with physical deficits also indicates a poor walking prognosis in pediatric CP.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Rehabilitation Medicine
Context:
- Cerebral palsy (CP) is a group of permanent disorders of the development of movement and posture, causing activity limitation, attributed to non-progressive disturbances in the developing fetal or infant brain.
- Assessing prognostic factors for ambulation in children with CP is crucial for early intervention and therapeutic planning.
- This study retrospectively analyzed data from 100 children with CP treated between 1979 and 1988.
Purpose:
- To identify key factors predicting the prognosis for walking ability in children diagnosed with cerebral palsy.
- To analyze the correlation between specific developmental milestones, motor function, cognitive status, and upper limb function with walking capability.
Summary:
- The study analyzed motor dysfunction severity, age of sitting balance acquisition, upper limb function, cognitive impairment, and primitive reflexes in 100 children with CP.
- Factors indicating a poor prognosis for walking included severe motor dysfunction, delayed sitting balance acquisition (after age 3), precarious upper limb function, and severe intellectual disability coupled with severe physical deficits.
- Primitive reflexes showed no direct correlation with walking prognosis.
Impact:
- These findings aid clinicians in predicting walking outcomes for children with cerebral palsy, enabling tailored rehabilitation strategies.
- Early identification of poor prognostic indicators can guide parental counseling and resource allocation for long-term care planning.
- Understanding these prognostic markers contributes to the broader knowledge base for managing pediatric neurological conditions and improving functional independence.
Abstract:
With the objective of studying the prognosis for walking in children with cerebral palsy a retrospective survey of 100 children being treated at the Associação de Assistência à Criança Defeituosa was made during the period from 1979 to 1988. The following parameters were analysed: (1) degree of motor dysfunction; (2) age of acquisition of sitting balance; (3) function of upper limbs; (4) degree of mental retardation; (5) presence of primitive reflexes. All the above parameters were analysed with respect to the capability of children acquiring or not walking. The results of our study show that the following factors are indicative of bad prognosis for walking: (1) severity of motor dysfunction; (2) acquisition of sitting posture after 3 years old; (3) precarius function of upper limbs; (4) severe mental retardation associated with severe physical deficiency. Clinical evaluation of primitive reflexes did not reveal direct relation to the walking prognosis.