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Walking prognosis in cerebral palsy: a 22-year retrospective analysis
A C da Paz Júnior1, S M Burnett, L W Braga
1Cerebral Palsy Unit, SARAH/HAL, Brasília-DF, Brazil.
Insights
Early gross motor milestones in children with cerebral palsy (CP) predict walking prognosis. Achieving head balance before 9 months and sitting by 24 months are favorable indicators for ambulation.
Area of Science:
- Neurology
- Pediatrics
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Predicting ambulation potential in children with CP is crucial for early intervention and management.
- Gross motor milestones are key indicators of neurological development in infants and children.
Purpose of the Study:
- To identify prognostic criteria for ambulation in children with spasticity.
- To establish age-based milestones predictive of walking ability in pediatric cerebral palsy.
- To develop a tool for assessing walking prognosis in children with CP.
Main Methods:
- Retrospective study of 272 patients diagnosed with spasticity.
- Analysis of clinical data including age at last assessment, CP type, and attainment ages of gross motor milestones.
- Statistical evaluation to determine the predictive value of specific milestones for ambulation.
Main Results:
- Head balance before 9 months correlated with a good prognosis for walking.
- Attainment of sitting by 24 months indicated a favorable outcome.
- Crawling by 30 months was a significant predictor of good prognosis, while delayed milestones indicated poor prognosis.
Conclusions:
- Age-specific gross motor milestones serve as reliable predictors of walking prognosis in children with cerebral palsy.
- Early achievement of head balance, sitting, and crawling are associated with better ambulation outcomes.
- A prognostic chart based on these milestones can aid clinicians in predicting walking ability.
Abstract:
A retrospective study was performed of 272 patients with spasticity to determine criteria for the prognosis for ambulation based on the ages at which children with cerebral palsy attain important gross motor milestones. The variables analysed were age at last clinical assessment, clinical type of cerebral palsy and ages at attainment of gross motor milestones. Achievement of head balance before nine months was an important parameter for good prognosis for walking and, after 20 months of age, an indicator for poor prognosis. Sitting by 24 months indicated a favourable outcome, and motor control of crawling at 30 months of age was a predictor for good prognosis. Based on these data, a chart for walking prognosis in children with cerebral palsy is presented.