Meritve naprednih motoričnih sposobnosti z ocenjevalno listo Challenge pri otrocih s cerebralno paralizo

Milaščević, Darko (author), Neubauer, David (mentor), Wright, Virginia (co-mentor)

CILJ: Razviti starostne norme za Challenge-20 za otroke s tipičnim razvojem (TR) in ugotoviti kako so rezultati otrok s cerebralno paralizo (CP) s stopnjo I in II na lestvici klasifikacijskega sistema glede na grobo motorične sposobnosti (GMFCS) primerljivi s temi starostnimi normami . METODA: 150 TR otrok, 7-12 let (m = 69; f = 81) v 5 starostnih skupinah je bilo vključenih in testiranih z uporabo Challenge-20 za določitev starostnih norm, ki smo jih potem primerjali z rezultati Challenge-20 otrok s CP (n = 191), stopnja GMFCS I (n = 135) in II (n = 56), starosti 5-18 let. REZULTATI: Referenčne krivulje po starosti in ocena Challenge-20, narisane od 1. do 95. percentila. Mlajši TR otroci (7 - 8 let) so imeli nižjo oceno (~ 50%), starejši otroci (9 - 12 let) pa > 85% in več na Challenge-20, , kar govori za podobne razvojne poti/trajektorije. Otroci s CP sledijo podobni poti, čeprav nižji, kot pri TR otrocih in kažejo nadaljevanje napredovanja tudi po 12. letu, njihovi najvišji rezultati pa so se približali ali prekrivali (15% primerov) najnižjim rezultatom TR otrok. INTERPRETACIJA: Challenge-20 je občutljiv test za dokazovanje napredovanja grobo motoričnih sposobnosti TR otrok. Otroci s CP GMFCS stopnje I sledijo podobni, čeprav nižji poti testnih rezultatov Challenge-20 kot TR otroci, v nekaterih primerih pa se približajo sposobnostim TR otrok z najnižjimi rezultati. Referenčne percentilne krivulje razširjajo klinično uporabnost Challenge-20 in odpirajo vrata za ponovno razmišljanje o naprednih grobo motoričnih interventnih posegih za otroke s CP s stopnjama GMFCS I in II glede na njihov potencial za napredovanje po razvojnih poteh/trajektorijih.

• Language: Slovenian
• Keywords: ocena fizioterapije, cerebralna paraliza, percentilne krivulje, napredna grobo motorična funkcija, Challenge-20.
• Work type: Doctoral dissertation
• Organization: MF - Faculty of Medicine
• Year: 2022
• PID: 20.500.12556/RUL-141958
• COBISS.SI-ID: 142494467
• Publication date in RUL: 13.10.2022

Secondary language

• Language: English
• Title: Measuring advanced motor skills with Challenge assessment in children with cerebral palsy

Abstract

AIM: To develop age related norms for the Challenge-20 assessment with typically developing (TD) children and explore how scores of children with cerebral palsy (CP) in Gross Motor Function Classification Scale (GMFCS) level I and II compare to these age norms. METHOD: 150 TD children 7 - 12 years (69 male=69; 81 female) in 5 age groups were enrolled and tested using Challenge-20 to determine age related norms, and compared with Challenge-20 results of children with CP (n=191), GMFCS level I (n = 135) and II (n = 56), 5-18 years. RESULTS: Reference curves by age and Challenge-20 score, were plotted across the 1st to 95th percentiles. Younger TD children (7 - 8 years) scored lower (~50%) and older children (9 - 12 years) scored >85% and higher on the Challenge-20 showing similar developmental trajectories. Children with CP followed similar, albeit lower, Challenge-20 score trajectory to that of TD children with continued progression beyond age 12, and the highest scores came close or overlapped (15% of cases) the lowest scores of TD children. INTERPRETATION: The Challenge-20 is sensitive to progression in advanced gross motor skills in TD children. Children with CP in GMFCS level I follow similar, but lower, Challenge score trajectory to that of TD children, and in some cases come close to lower level abilities of TD children. The reference percentiles extend the clinical utility of the Challenge-20 and open the door to thinking more about advanced gross motor interventions for children with CP in GMFCS levels I and II given their potential to progress along the developmental trajectory.

• Keywords: physiotherapy assessment, cerebral palsy, percentile curves, advanced gross motor function, Challenge-20.