Longitudinal changes in health-related quality of life in preschool children with cerebral palsy of different levels of motor severity.
Severe CP in preschool predicts lower quality of life and emotional decline over six months, so watch mood closely.
01Research in Context
What this study did
The team followed preschoolers with cerebral palsy for six months. They split the kids by GMFCS level, a five-step scale that tells how much help a child needs to move. Parents filled out the CP QOL-Child form twice to show changes in physical, cognitive, and emotional quality of life.
What they found
Children at GMFCS level V started with the lowest quality-of-life scores. After six months their physical and cognitive scores rose, but their emotional scores dropped. Kids at levels I-II stayed steady in all areas.
How this fits with other research
Kocher et al. (2015) tracked the same age group for the same six months. They saw that younger boys with lower cognition lost the most ground in everyday activities. Together the two papers show that the same kids who lose participation also lose emotional well-being.
Chen et al. (2013) proved the CP QOL-Child form works in Chinese families. Chih-Jou et al. used that same form, so the score changes can be trusted.
Arnfield et al. (2013) linked MRI lesion type to GMFCS level. Their review supports using GMFCS as a quick way to spot which preschoolers need closer emotional monitoring.
Why it matters
If you serve preschoolers with CP, treat GMFCS level V as a red flag for mood. Plan extra emotional check-ins even while you celebrate small physical gains. Share the six-month data with families so they expect possible emotional dips and know to ask for help early.
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02At a glance
03Original abstract
BACKGROUND: When setting goals for cerebral palsy (CP) interventions, health-related quality of life (HRQoL) is an important outcome. AIMS: To compare longitudinal changes in HRQoL in children with CP of different levels of motor severity. METHODS AND PROCEDURES: Seventy-three children with CP were collected and classified into three groups based on Gross Motor Function Classification System (GMFCS) levels. HRQoL was assessed by parent's proxy of the TNO-AZL Preschool Quality of Life (TAPQOL) at baseline and 6 months later. OUTCOMES AND RESULTS: Children with GMFCS level V had a lower total TAPQOL score and scores in all domains than those with level I-IV (p<0.01), except for the non-motor subdomain of physical functioning at follow-up. With regards to longitudinal changes, the children with GMFCS level V had greater improvements in physical (p=0.016) and cognitive functioning (p=0.042), but greater deterioration in emotional functioning (p=0.008) than those with levels I-II at 6 months of follow-up. CONCLUSIONS AND IMPLICATIONS: Motor severity was associated with TAPQOL scores in all domains and changes in some domains in children with CP. Clinicians should early identify children at risk of a poor HRQoL and plan timely treatment strategies to enhance the HRQoL of children with CP.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2016.11.013