J Korean Med Sci.  2017 May;32(5):873-879. 10.3346/jkms.2017.32.5.873.

Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay

• Hong BY
• Jo L
• Kim JS
• Lim SH
• Bae JM

• KMID: 2375091
• DOI: http://doi.org/10.3346/jkms.2017.32.5.873

Abstract

The study was designed to identify factors influencing the short term effect of intensive therapy on gross motor function in children with cerebral palsy or developmental delay. Retrospectively, total Gross Motor Function Measure-88 (GMFM-88) scores measured during the first and last weeks of intensive therapy were analyzed (n = 103). Good and poor responder groups were defined as those in the top and bottom 25% in terms of score difference, respectively. The GMFM-88 score increased to 4.67 ± 3.93 after 8 weeks of intensive therapy (P < 0.001). Gross Motor Function Classification System (GMFCS) level (I-II vs. IV-V; odds ratio [OR] = 7.763, 95% confidence interval [CI] = 2.177-27.682, P = 0.002) was a significant factor in a good response to therapy. Age (≥ 36 months; OR = 2.737, 95% CI = 1.003-7.471, P = 0.049) and GMFCS level (I-II vs. IV-V; OR = 0.189, 95% CI = 0.057-0.630, P = 0.007; and III vs. IV-V; OR = 0.095, 95% CI = 0.011-0.785, P = 0.029) were significantly associated with a poor response. GMFCS level is the most important prognostic factor for the effect of intensive therapy on gross motor function. In addition, age ≥ 36 months, is associated with a poor outcome.

Keyword

Cerebral Palsy; Developmental Disabilities; Rehabilitation; Early Intervention

MeSH Terms

Cerebral Palsy*
Child*
Classification
Developmental Disabilities
Early Intervention (Education)
Humans
Odds Ratio
Rehabilitation
Retrospective Studies

Figure

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  Fig. 1 The cost of physical therapy of children and adolescents in South Korea from 2010 to 2014.

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  Fig. 2 Differences in GMFM-88 score after 8 weeks of intensive therapy according to the GMFCS level.GMFM = gross motor function measure, GMFCS = gross motor function classification system.*,†,‡,§The post-hoc tests to identify the pairs of means that differ, P<0.05.

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