Factors for changes in self-care and mobility capabilities in young children with cerebral palsy involved in regular outpatient rehabilitation care

• Published in: Heliyon Vol. 7; no. 12; p. e08537
• Main Authors: de Leeuw, Marleen J., Schasfoort, Fabienne C., Spek, Bea, van der Ham, Inez, Verschure, Stella, Westendorp, Tessa, Pangalila, Robert F.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2021; Elsevier
• Subjects: Cerebral palsy; Mobility; Paediatric rehabilitation; Self-care; Mobility; Cerebral palsy; Paediatric rehabilitation; Self-care
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2021.e08537

Assessing prognosis of self-care and mobility capabilities in children with cerebral palsy (CP) is important for goal setting, treatment guidance and meaningful professional-caregiver conversations. Identifying factors associated with changes in self-care and mobility capabilities in regular outpatient multidisciplinary paediatric CP rehabilitation care. Routinely monitored longitudinal data, assessed with the Paediatric Evaluation of Disability Inventory (PEDI-Functional-Skills-Scale, FSS 0–100) was retrospectively analysed. We determined contributions of age, gross-motor function, bimanual-arm function, intellectual function, education type, epilepsy, visual function, and psychiatric comorbidity to self-care and mobility capability changes (linear-mixed-models). For 90 children (53 boys), in all Gross-Motor-Function-Classification-System (GMFCS) levels, 272 PEDI's were completed. Mean PEDI–FSS–scores at first measurement (median age: 3,2 years) for self-care and mobility were 46.3 and 42.4, and mean final FSS-scores respectively were 55.1 and 53.1 (median age: 6,5 years). Self-care capability change was significantly associated with age (2.81, p < 0.001), GMFCS levels III-V (-9.12 to -46.66, p < 0.01), and intellectual impairment (-6.39, p < 0.01). Mobility capability change was significantly associated with age (3.25, p < 0.001) and GMFCS levels II-V (-6.58 to -47.12, p < 0.01). Most important prognostic factor for self-care and mobility capabilities is GMFCS level, plus intellectual impairment for self-care. Maximum capability levels are reached at different ages, which is important for individual goal setting and managing expectations. •Capabilities of children with CP improve modestly over time in outpatient rehabilitation.•Children with more severe CP reach maximum mobility and self-care levels at an earlier age.•After this maintaining capabilities is more realistic than improvement.•Important prognostic factors are GMFCS level and intellectual impairment.•Routine monitoring can aid goal setting and expectation management in communication with families. Cerebral palsy, Paediatric rehabilitation, Self-care, Mobility.