Article

The aim of this study was to describe the distribution of motor severity
levels and temporal trends in an Australian population cohort and to review the
distribution of Gross Motor Function Classification System (GMFCS) levels across
cerebral palsy (CP) registries worldwide. METHODS: Data were extracted from the
Victorian Cerebral Palsy Register for 3312 individuals (1852 males, 1460 females;
mean age 21y 2mo [SD 9 y 6 mo]) with non-postneonatally acquired CP, born between
1970 and 2003. The proportions of each motor severity level were calculated and
logistic regression analyses were used to assess trends over time. A systematic
review of the literature was undertaken and GMFCS data were extracted based on
previously devised criteria. The proportions were plotted and the degree of
heterogeneity was assessed for each level. RESULTS: Population data from Victoria
suggested a proportional increase in mild motor impairment (GMFCS levels I/II)
from 54% of all cases of CP in the 1970s to 61% in the 2000s. For nine CP
registries worldwide, the mean proportions of each GMFCS level, from level I to
V, were 34.2%, 25.6%, 11.5%, 13.7%, and 15.6% respectively. There was substantial
heterogeneity between registries for all levels except level III. INTERPRETATION:
Despite the usefulness and reported reliability of the GMFCS, substantial
variability was found in the distribution of GMFCS levels between population
registries, particularly between levels I and II, suggesting greater
classification uncertainty between these levels. Further research would be useful
to determine whether routine collection of extra clinical information may
facilitate more reliable classification.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS