Gross Motor Function in Children with Congenital Zika Syndrome
Eliana Harumi Morioka Takahasi1,2, Maria Teresa Seabra Soares de Britto Alves2, Marizélia Rodrigues Costa Ribeiro2
1Sarah Network of Neurorehabilitation Hospitals, São Luís, Maranhão, Brazil.
Insights
Congenital Zika syndrome (CZS) children often have severe cerebral palsy and limited gross motor function. Most CZS children show no improvement by age three, indicating they may have reached their maximum potential.
Area of Science:
- Neurology
- Pediatrics
- Developmental Pediatrics
Background:
- Limited data exists on the gross motor function of children with congenital Zika syndrome (CZS).
- Understanding motor development is crucial for early intervention and support for affected children.
Purpose of the Study:
- To assess gross motor function in children with CZS up to three years old.
- To identify factors associated with motor function and track changes over time.
Main Methods:
- Evaluated 100 CZS children (confirmed and presumed) using the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66).
- 46 children were reassessed after a minimum of six months to track changes.
- Statistical analyses included Wilcoxon tests and percentile score comparisons.
Main Results:
- 89% of CZS children were classified as GMFCS level V, indicating severe motor impairment.
- Low socioeconomic status, microcephaly, epilepsy, and brain volume loss correlated with lower GMFM scores.
- While some individuals showed improvement, most CZS children, particularly those in GMFCS level V, exhibited no significant gross motor function gains by age three.
Conclusions:
- The majority of CZS children experience severe cerebral palsy and demonstrate minimal gross motor function improvement by their third year.
- These findings suggest that CZS children may reach their maximal gross motor potential early in life.
- Early and targeted interventions may be essential to maximize functional outcomes for these children.
Background:
Little information on gross motor function of congenital Zika syndrome (CZS) children is available.
Objectives:
To evaluate gross motor function in CZS children aged up to 3 years, and its associated factors and changes in a minimum interval of 6 months.
Methods:
One hundred children with CZS and cerebral palsy (36 with confirmed and 64 with presumed CZS) were evaluated with the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66). Forty-six were reevaluated. Wilcoxon tests, Wilcoxon tests for paired samples, percentile scores, and score changes were performed.
Results:
Clinical and socioeconomic characteristics (except maternal age), GMFM scores and GMFCS classification of confirmed and probable cases, which were analyzed together, were similar. The mean age was 25.6 months (±5.5); the median GMFM-88 score was 8.0 (5.4-10.8); and the median GMFM-66 score was 20.5 (14.8-23.1); 89% were classified as GMFCS level V. Low economic class, microcephaly at birth, epilepsy, and brain parenchymal volume loss were associated with low GMFM-66 scores. The median GMFM-66 percentile score was 40 (20-55). On the second assessment, the GMFM-66 scores in two GMFCS level I children and one GMFCS level IV child improved significantly. In one GMFCS level III child, one GMFCS level IV child, and the group of GMFCS level V children, no significant changes were observed.
Conclusions:
Almost all CZS children had severe cerebral palsy; in the third year of life, most presented no improvement in gross motor function and were likely approaching their maximal gross motor function potential.
