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Prognostic Predictors for Ambulation in Thai Children With Cerebral Palsy Aged 2 to 18 Years
Orawan Keeratisiroj1, Nuanlaor Thawinchai2, Wantana Siritaratiwat3
1Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Faculty of Public Health, Naresuan University, Phitsanulok, Thailand.
Insights
Independent sitting and eating by age 2 predict ambulation in Thai children with cerebral palsy. This study identified key prognostic predictors for walking ability in pediatric cerebral palsy patients.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Predicting ambulatory status is crucial for early intervention and management in children with CP.
- Understanding prognostic factors can guide therapeutic strategies and improve patient outcomes.
Purpose of the Study:
- To identify prognostic predictors for ambulation in Thai children with cerebral palsy.
- To determine the ambulatory status of children with CP in Thailand.
- To develop a clinical scoring system for predicting walking ability.
Main Methods:
- Retrospective cohort study involving 533 Thai children (aged 2-18 years) with CP.
- Participants were classified based on their ambulatory status using the Gross Motor Function Classification System (GMFCS I-V).
- Multivariable ordinal continuation ratio logistic regression was used to analyze prognostic predictors.
Main Results:
- Significant positive predictors for ambulation included specific types of cerebral palsy (spastic diplegia, hemiplegia, dyskinesia, ataxia, hypotonia, mixed type).
- Independent sitting by age 2 years and independent eating were strong positive predictors of ambulation.
- The study categorized participants into independent ambulators (GMFCS I-II), assisted ambulators (GMFCS III), and non-ambulators (GMFCS IV-V).
Conclusions:
- Type of cerebral palsy, independent sitting by age 2, and independent eating are significant predictors of ambulation.
- These findings can inform the development of a clinical scoring tool for predicting ambulation in Thai children with CP.
- Early identification of prognostic factors can optimize rehabilitation and support for children with cerebral palsy.
Abstract:
The objectives of this study were to determine prognostic predictors for ambulation among Thai children with cerebral palsy and identify their ambulatory status. A retrospective cohort study was performed at 6 special schools or hospitals for children with physical disabilities. The prognostic predictors for ambulation were analyzed by multivariable ordinal continuation ratio logistic regression. The 533 participants aged 2 to 18 years were divided into 3 groups: 186 with independent ambulation (Gross Motor Function Classification System [GMFCS I-II]), 71 with assisted ambulation (Gross Motor Function Classification System III), and 276 with nonambulation (Gross Motor Function Classification System IV-V). The significant positive predictors for ambulation were type of cerebral palsy (spastic diplegia, spastic hemiplegia, dyskinesia, ataxia, hypotonia, and mixed type), sitting independently at age 2 years, and eating independently. These predictors were used to develop clinical scoring for predicting the future ability to walk among Thai children with cerebral palsy.
