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Prognostic value of gross motor function measure to evaluate the severity of cerebral palsy
I Natroshvili1, Z Kakushadze, M Gabunia
1The Center of Child Neurology and Neurorehabilitation, Tbilisi, Georgia.
Insights
The Gross Motor Function Measure (GMFM) helps predict long-term motor disability in children with cerebral palsy. Most children reach 90% of their motor function by age five, guiding rehabilitation and participation strategies.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Early and accurate assessment of motor development is crucial for children with cerebral palsy (CP).
- Effective prognosis informs rehabilitation strategies and preventive measures.
- Understanding long-term motor disability aids parental counseling and clinical management.
Purpose of the Study:
- To evaluate the Gross Motor Function Measure (GMFM) for assessing CP severity.
- To determine the GMFM's utility in prognostic counseling for parents.
- To guide clinical management planning for children with CP.
Main Methods:
- Longitudinal observation of 397 children (aged 1-12 years) with CP over 3.5 years (2002-2005).
- Assessment using the Gross Motor Function Measure (GMFM-88) and Gross Motor Function Classification System (GMFCS).
- Total of 6875 GMFM assessments conducted, averaging 17.3 per child.
Main Results:
- Significant differences observed in the developmental limits across GMFCS levels.
- Children with lower motor potential reached their functional limits earlier.
- Children with CP achieved approximately 90% of their gross motor function by age 5 or younger, varying by GMFCS level.
Conclusions:
- The GMFM is valuable for assessing CP severity and prognosis.
- Motor development plateaus around age 5, necessitating a shift in intervention focus.
- Post-age 5 interventions should prioritize independent activity and participation for children with disabilities.
Abstract:
Early adequate evaluation of motor development and prognosis of degree of long-term motor disability is very important not only for parents, but also for correct management of goal oriented rehabilitation treatment and for planning of preventive measures. To estimate the value of Gross Motor Function Measure in evaluation of severity of cerebral palsy, for prognostic counseling with parents and for planning of clinical management. Total of 397 children aged 1 to 12 years at study onset with cerebral palsy were observed for up to 3,5 years during the period from 2002 to 2005. Children were assessed by GMFM-88 (Gross Motor Function Measure), by GMFCS (Gross Motor Function Classification System). Over the course of the study 397 children had a total of 6875 GMFM assessments, or an average of 17,3 observations per child. The study revealed significant differences between developmental limit of each level of gross motor function. Children with lower motor development potential reach their limit more quickly, than children with higher potentials. Children with cerebral palsy reach about 90% of their gross motor function by around age 5 years or younger, depending on their GMFCS level. After this age intervention programs have to address increasing independent activity and to promote participation of children with disabilities.
