Motor Severity in Children With Cerebral Palsy Studied in a High-Resource and Low-Resource Country

Abstract

OBJECTIVES: To compare the patterns of motor type and gross motor functional severity in preschool-aged children with cerebral palsy (CP) in Bangladesh and Australia. METHODS: We used comparison of 2 prospective studies. A total of 300 children with CP were aged 18 to 36 months, 219 Australian children (mean age, 26.6 months; 141 males) recruited through tertiary and community services, and 81 clinic-attendees born in Bangladesh (mean age, 27.5 months; 50 males). All children had diagnosis confirmed by an Australian physician, and birth and developmental history collected on the Physician Checklist. All children were classified by the same raters between countries using the Gross Motor Function Classification System (GMFCS), and motor type and distribution. RESULTS: There were more children from GMFCS I–II in the Australian sample (GMFCS I, P < .01; III, P < .01; V, P = .03). The patterns of motor type also differed significantly with more spasticity and less dyskinetic types in the Australian sample (spasticity, P < .01; dystonia, P < .01; athetosis, P < .01). Birth risk factors were more common in the Bangladesh sample, with risk factors of low Apgar scores (Australia, P < .01), lethargy/seizures (Australia, P = .01), and term birth (Bangladesh, P = .03) associated with poorer gross motor function. Cognitive impairments were significantly more common in the Bangladesh children (P < .01), and visual impairments more common in Australia (P < .01). CONCLUSIONS: Patterns of functional severity, motor type, comorbidities, etiology, and environmental risk factors differed markedly between settings. Our results contribute to understanding the patterns of CP in low-resource settings, and may assist in optimizing service delivery and prioritizing appropriate early interventions for children with CP in these settings.

The Effectiveness of a Computer Game-Based Rehabilitation Platform for Children With Cerebral Palsy: Protocol for a Randomized Clinical Trial

“…There are different approaches to therapy for children with CP [10-17]. The effectiveness of these programs is proportional to the intensity and amount of training and the task-specificity of the exercise regime [18-21].…”

Children with motor impairment related to cerebral palsy: Prevalence, severity and concurrent impairments in China

“…More details concerning the criteria and screening scale of DQ and IQ were stated in our published work . The concurrent impairments selected in this study were on the basis of previous studies …”

“…Due to its low incidence and prevalence, conducting a population‐based study with regard to CP is time consuming and fund costing. Consequently, a vast majority of epidemiological studies on CP were conducted in developed nations, as opposed to very few in developing countries . Apart from motor impairment, CP is also related to additional disorders .…”

“…Apart from motor impairment, CP is also related to additional disorders . For instance, the prevalence rates of cognitive, visual and hearing comorbidities of children with CP were roughly 31, 34 and 7% in Australia as opposed to 83, 27 and 3% in Bangladesh, respectively . As well, studies regarding potential risk factors for CP are abundant and these factors were categorised as prenatally, perinatally and post‐natally acquired …”

Cerebral Palsy. A Life Filled with All Sorts of Difficulties

“…The clinical state of these children is determined by motoric, cognitive and perceptive disorders, subject to a stable lesion overtime. Regarding energy requirements, CP children have specific needs, due to clinical variability and therapy requirements [1]. The capacity to reach a sufficient suitable oral ingestion is priority.…”