Elizabeth Maus, Ben Reader, Jill C Heathcock

Abstract

Aims: To quantify the number and types of mobility devices used by children with cerebral palsy (CP) and explore the relationships between Gross Motor Functional Classification System (GMFCS) level, age, insurance, income, and number and types of devices.

Method: This was a secondary analysis of a cohort from a larger randomized controlled trial. Data from 89 children with CP (56.2% male and 43.8% female; mean = 4 years 11 months; SD = 2 years 0 months; range 2 years 0 months-8 years 10 months) were collected from electronic medical records, parent-completed medical history questionnaires, and the Hollingshead Four-Factor Index. The analysis included quasi-Poisson and logistical regressions.

Results: Most children had Medicaid insurance (83.2%). All income and GMFCS levels were represented. The most common mobility devices were lower-extremity orthoses (75.3%). The number of devices used increased by 8.2% for each 1-year increase in age. Children classified in GMFCS level V used 5.1, 2.9, and 1.6 times more mobility devices than children classified in GMFCS levels I, II, and III respectively. GMFCS level also predicted the use of wheelchairs, bath chairs, and standers. Income and insurance were not significant.

Interpretation: Children used more devices as age and GMFCS level increased. Device access is an important public health initiative.

Stina Oftedal, Simona Fiori, Kristie L Bell, Katherine A Benfer, Leanne Sakzewski, Robert S Ware, Peter S W Davies, Roslyn N Boyd

• PMID: 40745624
• DOI: 10.1111/dmcn.16427

Abstract

Aim: To investigate the relationship between growth, body composition, and the extent of brain lesion measured using structural magnetic resonance imaging (MRI) in children with cerebral palsy (CP).

Method: This prospective population-based cohort study recorded 359 assessments from 124 children with CP aged 18 months to 13 years (38% female, Gross Motor Function Classification System [GMFCS] levels I = 50, II = 24, III = 17, IV = 12, and V = 21). A neurologist assessed the extent of the brain lesion using a validated semi-quantitative scale (global, basal ganglia/brainstem, hemispheric and corpus callosum scores). Height (HTZ), weight (WTZ), and head circumference (HDZ) z-scores were calculated. The Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) were determined using a deuterium dilution technique, bioelectrical impedance or dual-energy X-ray absorptiometry, and height. Data were analysed using mixed-effects linear regression.

Results: Greater global (β = -0.04, 95% confidence interval [CI] = -0.07 to -0.02), basal ganglia/brainstem (β = -0.06, 95% CI = -0.11 to -0.02), corpus callosum (β = -0.27, 95% CI = -0.27 to -0.12), and hemispheric (β = -0.08, 95% CI = -0.12 to -0.04) scores were associated with lower HTZ. Greater global (β = -0.03,95% CI = -0.06 to -0.01) and corpus callosum (β = -0.23, 95% CI = -0.40 to -0.06) scores were associated with lower WTZ. A greater hemispheric score (β = -0.06, 95% CI = -0.119 to -0.001) was associated with lower HDZ. Semi-quantitative MRI scores were not associated with FMI or FFMI.

Interpretation: Greater extent of the brain lesion was significantly associated with lower HDZ, HTZ, and WTZ but not body composition in children with CP aged 18 months to 13 years.

Keywords: Body composition; Brain imaging; Brain lesion; Cerebral palsy; Growth.

Our preview of the upcoming AACPDM Conference in New Orleans USA.

We look ahead at The American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) Conference - the 79th Annual Meeting!

“Celebrating Resilience” October 15-18, 2025, to be held in New Orleans, LA.

We catch up with AACPDM First Vice President Dr Theresa Sukal-Moulton and Scientific Program Committee Co-Chair Dr Paige Church.

You can still register at the link below!

https://www.aacpdm.org/events/2025