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A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy
Published on: November 3, 2016
Motor severity in children with cerebral palsy studied in a high-resource and low-resource country
Katherine A Benfer1, Rachel Jordan2, Sasaka Bandaranayake3
1Queensland Cerebral Palsy and Rehabilitation Research Centre, The School of Medicine, Centre for the Rehabilitation of the Paralysed, Dhaka, Bangladesh; and katherine.benfer@uqconnect.edu.au.
Insights
Cerebral palsy (CP) patterns in children differ significantly between Bangladesh and Australia, impacting motor function, type, and associated conditions. Understanding these differences is key for tailored interventions in low-resource settings.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Global Health
Background:
- Cerebral palsy (CP) presents diverse clinical manifestations globally.
- Understanding variations in CP across different socioeconomic and environmental contexts is crucial for effective healthcare delivery.
Purpose of the Study:
- To compare motor type and gross motor functional severity in preschool-aged children with CP in Bangladesh and Australia.
- To identify differences in comorbidities, etiology, and environmental risk factors between the two countries.
Main Methods:
- Comparison of two prospective studies involving 300 children with CP (18-36 months).
- 219 children from Australia and 81 from Bangladesh were assessed.
- Classification using the Gross Motor Function Classification System (GMFCS) and standardized motor type assessment by the same raters.
Main Results:
- Australian children showed higher prevalence of GMFCS I-II, while Bangladesh had more GMFCS III and V.
- Spasticity was more common in Australia, whereas dyskinetic CP was less frequent.
- Birth risk factors and cognitive impairments were more prevalent in Bangladesh, while visual impairments were more common in Australia.
Conclusions:
- Significant differences exist in CP patterns, including functional severity, motor type, comorbidities, and risk factors between Bangladesh and Australia.
- Findings highlight the need for context-specific interventions and service delivery optimization for children with CP, particularly in low-resource settings.
Objectives:
To compare the patterns of motor type and gross motor functional severity in preschool-aged children with cerebral palsy (CP) in Bangladesh and Australia.
Methods:
We used comparison of 2 prospective studies. A total of 300 children with CP were aged 18 to 36 months, 219 Australian children (mean age, 26.6 months; 141 males) recruited through tertiary and community services, and 81 clinic-attendees born in Bangladesh (mean age, 27.5 months; 50 males). All children had diagnosis confirmed by an Australian physician, and birth and developmental history collected on the Physician Checklist. All children were classified by the same raters between countries using the Gross Motor Function Classification System (GMFCS), and motor type and distribution.
Results:
There were more children from GMFCS I-II in the Australian sample (GMFCS I, P < .01; III, P < .01; V, P = .03). The patterns of motor type also differed significantly with more spasticity and less dyskinetic types in the Australian sample (spasticity, P < .01; dystonia, P < .01; athetosis, P < .01). Birth risk factors were more common in the Bangladesh sample, with risk factors of low Apgar scores (Australia, P < .01), lethargy/seizures (Australia, P = .01), and term birth (Bangladesh, P = .03) associated with poorer gross motor function. Cognitive impairments were significantly more common in the Bangladesh children (P < .01), and visual impairments more common in Australia (P < .01).
Conclusions:
Patterns of functional severity, motor type, comorbidities, etiology, and environmental risk factors differed markedly between settings. Our results contribute to understanding the patterns of CP in low-resource settings, and may assist in optimizing service delivery and prioritizing appropriate early interventions for children with CP in these settings.
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