1. Relationship between changes in motor capacity and objectively measured motor performance in ambulatory children with spastic cerebral palsy
- Author
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Halma, Elisabeth, Bussmann, Johannes Bernardus Josephus, van den Berg-Emons, Hendrika Johanna Gerarda, Sneekes, Emanuel Maria, Pangalila, Robert, Schasfoort, Fabienne Carmen, Stam, Henk, Becher, Jules, Steyerberg, Ewout, Horemans, Herwin, Dallmeijer, Annet, Polinder, Suzanne, Bolster, Eline, Viola, Irma, van Beek, Karlijn, Verheijden, Johannes, Rehabilitation Medicine, Erasmus School of Law, and Public Health
- Subjects
Male ,medicine.medical_specialty ,Actigraph ,physical behaviour ,Motor Activity ,Ambulatory Care Facilities ,Cerebral palsy ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Spastic cerebral palsy ,Physical medicine and rehabilitation ,International Classification of Functioning, Disability and Health ,030225 pediatrics ,Bayesian multivariate linear regression ,Outcome Assessment, Health Care ,Developmental and Educational Psychology ,medicine ,Spastic ,Humans ,0501 psychology and cognitive sciences ,Muscle Strength ,Prospective Studies ,Child ,Research Articles ,Physical Therapy Modalities ,business.industry ,Cerebral Palsy ,05 social sciences ,Public Health, Environmental and Occupational Health ,Gross Motor Function Classification System ,medicine.disease ,Walking Speed ,Preferred walking speed ,Motor Skills ,motor performance ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Ambulatory ,Female ,business ,motor capacity ,Research Article ,050104 developmental & child psychology - Abstract
Background Different interventions are offered to children with cerebral palsy (CP) to improve the activity domain of the international classification of functioning (ICF). In therapy settings, the focus is mostly on motor capacity, but the ultimate goal is to improve motor performance. We therefore examined if changes in motor capacity outcomes are accompanied by changes in objectively measured motor performance after a 3-month intensive treatment period in ambulatory children with CP. Methods A secondary analysis on prospective clinical trial data was performed using multivariate linear regression. Sixty-five children (37 boys and 28 girls) with spastic CP, mean age 7 years and 3 months, Gross Motor Function Classification System (GMFCS) levels I-III were involved in a distinct 3-month intensive treatment period. Motor capacity (Gross Motor Function Measure [GMFM], functional muscle strength [FMS], and walking speed [WS]) and motor performance (using three Actigraph-GT3X+-derived outcome measures) were measured at baseline, 12 and 24 weeks. Results No significant associations were found for any of the change scores ( increment (12)) between motor capacity and motor performance after a 12-week intensive treatment period. After 24 weeks, increment 24FMS (p = .042) and increment 24WS (p = .036) were significantly associated with changes in motor performance outcome measure percentage of time spent sedentary ( increment (24)%sedentary). In this model, 16% of variance of increment (24)%sedentary was explained by changes in motor capacity (p = .030). Conclusions Changes in motor capacity are mostly not accompanied by changes in objectively measured motor performance after an intensive treatment period for ambulatory children with CP. These findings should be taken into account during goal setting and are important to manage expectations of both short- and longer term effects of treatment programmes.
- Published
- 2019
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