Longitudinal Association Between Gross Motor Capacity and Neuromusculoskeletal Function in Children and Youth With...

Area of Science:

• Pediatric Rehabilitation
• Neurology
• Movement Science

Background:

• Cerebral palsy (CP) significantly impacts neuromusculoskeletal function and gross motor capacity in children and youth.
• Understanding the longitudinal associations between specific functional impairments and motor development is crucial for targeted interventions.

Purpose of the Study:

• To investigate the relationship between neuromusculoskeletal function and gross motor capacity over time in a cohort of children and youth with CP.
• To identify which specific components of neuromusculoskeletal function are most predictive of motor capacity changes.

Main Methods:

• A prospective cohort study involving 327 children and youth with CP (aged 5-20 years) across different Gross Motor Function Classification System levels.
• Neuromusculoskeletal function was assessed, including selective motor control (SMC), muscle strength, spasticity, and range of motion (ROM).
• Gross motor capacity was measured using the Gross Motor Function Measure-66 over a 2-4 year period.

Main Results:

• Selective motor control (SMC) demonstrated a significant positive association with gross motor capacity in both children and youth with CP.
• Muscle strength was associated with gross motor capacity specifically in the youth cohort.
• Reduced hip ROM in children and knee extension ROM in youth, along with hip adductor spasticity in youth, showed weaker negative associations with motor capacity.

Conclusions:

• Impaired SMC is a primary determinant of a less favorable course of gross motor capacity in children and youth with CP.
• Reduced muscle strength in youth also contributes to poorer motor outcomes.
• While spasticity and reduced ROM have some impact, they appear less critical than SMC and strength for long-term motor development in this population.