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Prognosis for ambulation in cerebral palsy: a population-based study.
Yvonne W Wu1, Steven M Day, David J Strauss
1Department of Neurology, Box 0136, University of California-San Francisco, 500 Parnassus Ave, Room 411, San Francisco, CA 94143-0136, USA. wuy@neuropeds.ucsf.edu
Pediatrics
|November 3, 2004
Summary
This study identified key predictors of walking ability in children with cerebral palsy (CP). Early motor skills like sitting and pulling to stand significantly increase the likelihood of ambulation, aiding in prognosis.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) affects motor function, with ambulation being a key developmental milestone.
- Predicting walking potential in nonambulatory children with CP is crucial for intervention planning.
Purpose of the Study:
- To identify independent predictors of ambulation in children with CP.
- To develop a predictive tool for estimating a child's probability of walking.
Main Methods:
- Retrospective analysis of medical and functional data from 5366 children with CP (1987-1999).
- Logistic regression identified predictors of independent walking by age 6.
- Multistate survival analysis estimated probabilities of ambulation over time.
Main Results:
- 12.8% achieved independent walking and 18.4% walked with support by age 6.
- Key predictors included early motor milestones (sitting, pulling to stand), CP type (non-spastic quadriparesis), and preserved visual function.
- Ambulation charts were developed to predict outcomes through age 14.
Conclusions:
- Ambulation charts offer a simple method to estimate the likelihood of walking in nonambulatory children with CP.
- These charts aid in predicting ambulation with or without support for children aged 2-3.5 years.