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Research Article: Motor Development in Children with Cerebral Palsy in Sweden—A Population-Based Longitudinal Register Study

Date Published: 2023-11-28

Abstract:
The aim was to explore longitudinal motor development in children with cerebral palsy (CP) in Sweden with respect to the Gross Motor Function Classification System (GMFCS). In this national CP registry-based study, 2138 children aged 0.5–19 years participated (42% girls). The distribution with respect to GMFCS was I: 49%, II: 16%, III: 10%, IV: 14%, and V: 11%. In total, 5538 assessments (mean 2.7, min–max: 1–9) with the Gross Motor Function Measure-66 were included. Data were analysed using non-linear mixed-effects regression models, and the Stable Limit Model was selected to fit data. Five distinct curves of predicted gross motor development with respect to GMFCS levels were obtained. The achieved motor development was maintained over time. The estimated average GMFM-66 limit and the average age when 90% of the expected limits were reached were at GMFCS I: 88 at age 4.5; GMFCS II: 71 at age 4.2; GMFCS III: 54 at age 3.1; GMFCS IV: 38 at age 2.6, and at GMFCS V: 18 at age 0.9. In conclusion, this is the first national population-based study following motor development in CP. Five distinct curves reported in previous controlled research studies were confirmed. Our study adds knowledge about motor development captured in children’s everyday context.

Introduction:
Motor development such as rolling, sitting, crawling, and walking are essential for children’s early development and affects many aspects of health [1]. According to the definition from the World Health Organization, WHO, early development refers to the cognitive, physical, language, motor, social, and emotional development in children between 0 and 8 years of age [2]. Motor activities offer children the opportunity to discover, explore, and understand their surroundings and have shown beneficial effects on both…

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