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Reference centiles for the gross motor function measure and identification of therapeutic effects in children with
Ibrahim Duran1, Christina Stark2,3, Kyriakos Martakis2,4
1Center of Prevention and Rehabilitation, UniReha, University of Cologne, Cologne, Germany.
Insights
This study developed a method to track individual gross motor function changes in children with cerebral palsy (CP). It helps assess therapeutic intervention effects by accounting for natural progression in motor development.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomedical Engineering
Background:
- Children with cerebral palsy (CP) exhibit variable gross motor function development, peaking around ages 9-10.
- Estimating the impact of additional therapies in this age group is challenging due to natural fluctuations.
- A reliable method is needed to quantify individual motor changes over time.
Purpose of the Study:
- To develop a method for quantifying gross motor function changes over 6 months in individual children with CP.
- To aid clinicians in assessing the efficacy of therapeutic interventions.
- To establish a baseline for expected motor progression under standard care.
Main Methods:
- Retrospective analysis of data from children with CP undergoing rehabilitation (2006-2016).
- Utilized the Gross Motor Function Measurement (GMFM-66) for assessing gross motor function.
- Created reference centiles for GMFM-66 and analyzed 6-month observational data for variability.
Main Results:
- GMFM-66 data from 919 children pre-rehabilitation were analyzed.
- Data from 515 children were available for a 6-month observational phase, allowing assessment of standard care progression.
- Established variability in GMFM-66 evolution over 6 months.
Conclusions:
- The developed method enables clinicians to monitor individual gross motor development in children with CP.
- It facilitates the assessment of additional therapeutic intervention effects against expected standard care progression.
- Provides a quantitative tool for personalized pediatric rehabilitation planning.
Rationale, Aims, And Objectives:
Children with cerebral palsy (CP) can show an increase in gross motor function until the age of 9 to 10 years under the standard of care. Additionally, the motor development can have large individual fluctuations. Therefore, in clinical setting, it is not trivial to estimate the effect of an additional therapeutic intervention at this age interval. The study aim was to develop a method which allows quantification of the gross motor function changes over 6 months of the individual child with CP.
Method:
The present study was a single center retrospective analysis. Data were collected in children with CP who participated in a rehabilitation program between 2006 and 2016. The gross motor function of the children was measured with the Gross Motor Function Measurement (GMFM-66). Reference centiles for the GMFM-66 were created with data before starting the rehabilitation program. The variability of the evolution of the GMFM-66 was assessed with data at the start and the end of a 6-month observational phase of standard of care.
Results:
In total, the GMFM-66 data of 919 children before starting the rehabilitation program were available (age 6.49 ± 2.49 years, GMFCS-level I-V). For 515 study participants (6.76 ± 2.30 years, GMFCS-level I-V), data were also available at the start and the end of a 6-month observational phase.
Conclusions:
The presented method helps to guide the clinician to track the individual patient's gross motor development and assess the additional effect of an additionally applied intervention while taking into account the expected progression of gross motor function under standard of care.
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