Stability of motor impairment in children with cerebral palsy

Abstract

Classification of the quality and topographical pattern of motor impairment is used to describe cerebral palsy (CP). As an adjunct to a study characterizing the quality of life and participation of school-age children with CP, initial and follow-up classification of CP were compared. A cohort of 93 children (58 males, 35 females) were initially assessed at a mean age of 2 years 6 months (SD 2y 2mo) and re-assessed at 9 years 4 months (SD 2y 2mo) with a mean interval of 6 years 6 months (SD 2y 4mo) between assessments. Sixty children had Gross Motor Function Classification System levels I-III. All but one of the children were still classified has having CP at follow-up. Type of CP documented remained constant in 67 children (72%; 95% confidence interval 62-80). Clinical factors that were statistically significant (p <0.05) as possible predictors of CP subtype change were original classification of a non-spastic subtype or a non-spastic quadriparetic subtype. Change in CP subtype occurs in an appreciable minority of children with CP, which is likely to reflect a combination of intrinsic and extrinsic influences. Such change may challenge efforts to monitor the effects of interventions in this population. © 2008 Blackwell Publishing Ltd.