Longitudinal association between gross motor capacity and neuromusculoskeletal function in children and youth with cerebral palsy

Publication date: Available online 13 April 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Rimke C. Vos, Jules G. Becher, Jeanine M. Voorman, Jan Willem Gorter, Mirjam van Eck, Jetty van Meeteren, Dirk-Wouter Smits, Jos WR. Twisk, Annet J. Dallmeijer
ObjectiveTo examine associations over longitudinal measurements between neuromusculoskeletal function and gross motor capacity in children and youth with Cerebral Palsy (CP).DesignA prospective cohort studySettingRehabilitation departments of university medical centers and rehabilitations centers in The NetherlandsParticipants148 children (5-9 years) and 179 youth (11-20 years) with CP, GMFCS I(n=180), II(n=44), III(n=36), IV(n=34) and V(n=33).Interventionsnot applicableOutcome measuresGross motor capacity was assessed with the Gross Motor Function Measure (GMFM-66) over a period of 2-4 years in different age cohorts. Neuromusculoskeletal function included selective motor control (SMC), muscle strength, spasticity and range of motion (ROM) of the lower extremities.ResultsMulti-level analyses showed that SMC was significantly associated with gross motor capacity in children and youth with CP, showing higher values and a more favourable course in those with better SMC. Strength was only associated to gross motor capacity in youth. Reduced ROM of hip (children) and knee extension (youth) and spasticity of the hip adductors (youth) were additionally - but more weakly- associated with lower values and a less favourable course of gross motor capacity.ConclusionsResults indicate that children and youth with more severely impaired SMC and youth with reduced muscle strength have a less favourable course of gross motor capacity, while spasticity and reduced ROM are less determinative.



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