Study protocol: functioning curves and trajectories for children and adolescents with cerebral palsy in Brazil -
Paula S C Chagas1, Carolyne M Drumond2, Aline M Toledo3
1Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Universidade Federal de Juiz de Fora, Av. Eugênio do Nascimento, s / n - Dom Bosco, Juiz de Fora, Minas Gerais, Brazil. paula.chagas@ufjf.edu.br.
Insights
This study establishes prognosis curves for children with Cerebral Palsy (CP) in Brazil, using the Gross Motor Function Classification System (GMFCS) to guide care. Findings will inform public policy for improved lifelong support for individuals with CP.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Public Health
Background:
- Cerebral Palsy (CP) prognosis curves, crucial for clinical decision-making, were developed using Canadian data.
- There's limited understanding of CP development patterns in low-income countries like Brazil.
- The PARTICIPA BRAZIL study addresses this gap by examining Brazilian children and adolescents with CP.
Purpose of the Study:
- To profile functioning and disability in Brazilian children and adolescents with CP using five classification systems.
- To create longitudinal mobility trajectories based on the Gross Motor Function Classification System (GMFCS).
- To explore interrelationships among the International Classification of Functioning, Disability and Health (ICF) components and functional classification systems.
Main Methods:
- A multi-center, longitudinal, prospective cohort study involving 750 Brazilian children and adolescents with CP.
- Classification using five functional systems, with longitudinal evaluation of contextual factors, activity, participation, and body functions over four years.
- Development of prognosis curves using nonlinear mixed-effects models for GMFCS and Manual Abilities Classification System (MACS) levels, and multiple linear regression for ICF component interrelationships.
Main Results:
- Longitudinal trajectories of mobility, activity, participation, and body functions will be generated for different GMFCS and MACS levels.
- Interrelationships between ICF components and functional classification systems will be elucidated.
- Prognosis curves specific to the Brazilian population with CP will be established.
Conclusions:
- Study findings will characterize activities and participation levels in Brazilian youth with CP.
- Results will inform evidence-based public policies to enhance care from childhood to adulthood.
- The study provides crucial data for improving lifelong support and care for individuals with CP in Brazil.
Background:
Gross motor development curves for children with Cerebral Palsy (CP), grouped by Gross Motor Function Classification System (GMFCS) levels, help health care professionals and parents to understand children's motor function prognosis. Although these curves are widely used in Brazil to guide clinical decision-making, they were developed with Canadian children with CP. Little is known about how these patterns evolve in children and adolescents with CP in low-income countries like Brazil. The PARTICIPA BRAZIL aims to: (i) to identify and draw a profile of functioning and disability of Brazilian children and adolescents with CP by classifying them, for descriptive purposes, with all five valid and reliable functional classifications systems (gross motor function, manual ability, communication function, visual and eating and drinking abilities); (ii) to create longitudinal trajectories capturing the mobility capacity of Brazilian children and adolescents with CP for each level of the GMFCS; (iii) to document longitudinal trajectories in the performance of activities and participation of Brazilian children and adolescents with CP across two functional classification systems: GMFCS and MACS (Manual Abilities Classification System); (iv) to document longitudinal trajectories of neuromusculoskeletal and movement-related functions and exercise tolerance functions of Brazilian children and adolescents with CP for each level of the GMFCS; and (v) to explore interrelationships among all ICF framework components and the five functional classification systems in Brazilian children and adolescents with CP.
Methods:
We propose a multi-center, longitudinal, prospective cohort study with 750 Brazilian children and adolescents with CP from across the country. Participants will be classified according to five functional classification systems. Contextual factors, activity and participation, and body functions will be evaluated longitudinally and prospectively for four years. Nonlinear mixed-effects models for each of the five GMFCS and MACS levels will be created using test scores over time to create prognosis curves. To explore the interrelationships among ICF components, a multiple linear regression will be performed.
Discussion:
The findings from this study will describe the level and nature of activities and levels of participation of children and youth with CP in Brazil. This will support evidence-based public policies to improve care to this population from childhood to adulthood, based on their prognosis.
More Related Videos
11:29Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
07:20Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024