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Potential predictors of changes in gross motor function during various tasks for children with cerebral palsy: a
Chia-ling Chen1, Chung-yao Chen, Hsieh-ching Chen
1Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Kwei-Shan, Tao-Yuan 333, Taiwan.
Insights
Knee extensor strength predicts improvements in balance and coordination for children with cerebral palsy (CP). This finding highlights muscle strength as a key factor for gross motor function changes in CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Limited research exists on predictors of gross motor outcome changes in ambulatory children with cerebral palsy (CP).
- Understanding these predictors is crucial for optimizing therapeutic interventions and improving functional mobility.
Purpose of the Study:
- To identify potential predictors of change in gross motor outcomes among ambulatory children with CP.
- To explore the relationship between baseline characteristics and subsequent motor skill development.
Main Methods:
- A cohort of 45 ambulatory children with CP (aged 6-15 years) was studied.
- Potential predictors included age, gender, CP subtype, Gross Motor Function Classification System (GMFCS) levels, abdominal muscle endurance, and knee extensor/flexor strength (isokinetic dynamometry).
- Gross motor outcomes (running speed and agility, balance, bilateral coordination, strength, and a composite score) were assessed using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) at baseline and 12-week follow-up.
Main Results:
- Knee extensor strength significantly predicted changes in balance (BAL), bilateral coordination (BCO), and the gross motor composite (GMC) (adjusted R² = 0.07–0.19, P<0.05).
- Abdominal muscle strength negatively predicted changes in running speed and agility (RSA) (adjusted R² = 0.08, P<0.05).
- No significant predictors were found for the strength (STR) subtest.
Conclusions:
- Greater knee muscle strength in ambulatory children with CP may correlate with better responses to therapy and greater improvements in gross motor function.
- Knee muscle strength shows potential as a biomarker for predicting motor function changes in this population.
- Targeted strengthening of knee muscles could be a beneficial therapeutic strategy.
Abstract:
Very few studies have investigated predictors of change in various gross motor outcomes in ambulatory children with cerebral palsy (CP). The aim of this study was to identify potential predictors for change in gross motor outcomes measured during various tasks in children with CP. A group of 45 children (age, 6-15 years) with CP and 7 potential predictors were identified, including age, gender, CP subtypes, gross motor function classification system (GMFCS) levels, abdominal muscle endurance, and muscles strength of knee extensor and knee flexor measured by isokinetic dynanometer. Motor outcome was assessed by means of the gross motor composite (GMC) of Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), including four gross motor subtests: running speed and agility (RSA), balance (BAL), bilateral coordination (BCO), and strength (STR). The outcomes were measured at baseline and 12-week later (follow-up). The regression analyses showed that knee extensor strength was a robust predictor of change in BAL, BCO, and GMC (adjusted R(2) = 0.07-0.19, P<0.05). Additionally, abdominal muscle strength was a negative predictor for the changes in the RSA (adjusted R(2) = 0.08, P<0.05). However, STR model revealed no significant predictors. These findings suggest that ambulatory children with greater knee muscle strength may benefit more from therapy than those with lower strength. The knee muscle strength can be used as a biomarker to predict the changes in the gross motor functions.
