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    Motor severity in children with cerebral palsy studied in a high-resource and low-resource country

    Access Status
    Open access via publisher
    Authors
    Benfer, K.
    Jordan, R.
    Bandaranayake, S.
    Finn, C.
    Ware, R.
    Boyd, Roslyn
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Benfer, K. and Jordan, R. and Bandaranayake, S. and Finn, C. and Ware, R. and Boyd, R. 2014. Motor severity in children with cerebral palsy studied in a high-resource and low-resource country. Pediatrics. 134 (6): pp. e1594-e1602.
    Source Title
    Pediatrics
    DOI
    10.1542/peds.2014-1926
    ISSN
    0031-4005
    School
    School of Occupational Therapy and Social Work
    URI
    http://hdl.handle.net/20.500.11937/29838
    Collection
    • Curtin Research Publications
    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.

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