Article

OBJECTIVE: To analyze the development and progression of scoliosis in children
and adolescents with nonambulatory spastic tetraplegic cerebral palsy. DESIGN:
Retrospective longitudinal review. SETTING: Pediatric nursing home. PARTICIPANTS:
A total of 110 children and adolescents <18 years of age, with scoliosis.
MAIN OUTCOME MEASURES: Cobb angle, age, weight, height,
history of hip dislocation, tracheostomy. RESULTS: The Cobb angle increased with
age, weight, and height in a nonlinear fashion. A square root transformation of
the Cobb angle was chosen to model the nonlinear relationship between the Cobb
angle and predictors. Age, height, and weight were significant univariate
predictors of the square root of the Cobb angle (slopes = 0.377, 0.067, and 0.06,
respectively). In the multivariate mixed model, age remained a significant
predictor of the Cobb angle (slope = 0.456), but height and weight did not. If
the Cobb angle was > 40 degrees by age 12 years, scoliosis was more likely to
progress than if the Cobb angle was </= 40 degrees . The effect of age was
stronger for those with history of tracheostomy (age slope = 0.631 vs 0.281) than
those without. The relationship of age and Cobb angle did not differ
significantly between hip dislocated and non-hip-dislocated groups. CONCLUSIONS:
Age was found to be the most significant predictor of Cobb angle, and the effect
of age was greater in the tracheostomy group than in the nontracheostomy group.
After adjustment for age, the weight and height were not significant predictors
of Cobb angle. Cobb angles of > 40 degrees by the age of 12 years were associated
with greater increases in Cobb angle with age.
CI - Copyright A(c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS