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Gross motor function of children with down syndrome: Creation of motor growth curves,☆☆,,★★

Presented in part at the American Academy of Cerebral Palsy Developmental Medicine's annual meeting in Portland, OR, September 17, 1997 and the American Physical Therapy Association's annual meeting in Atlanta, GA, February 6, 1998.
https://doi.org/10.1053/apmr.2001.21956Get rights and content

Abstract

Palisano RJ, Walter SD, Russell DJ, Rosenbaum PL, Gémus M, Galuppi BE, Cunningham L. Gross motor function of children with Down syndrome: creation of motor growth curves. Arch Phys Med Rehabil 2001;82:494-500. Objective: To create gross motor function growth curves for children with Down syndrome (DS) and to estimate the probability that motor functions are achieved by different ages. Design: Nonlinear growth curve analysis by using a 2-parameter (rate, upper limit) model. Setting: Early intervention programs, schools, and children's homes. Participants: One hundred twenty-one children with DS, ages 1 month to 6 years. Main Outcome Measures: Gross Motor Function Measure (GMFM) and severity of motor impairment. Results: The curves for children with mild (n = 51) and moderate/severe (n = 70) impairment were characterized by a greater increase in GMFM scores during infancy and smaller increases as the children approached the predicted maximum score of 85.9 or 87.9. The estimated probability that a child would roll by 6 months was 51%; sit by 12 months, 78%; crawl by 18 months, 34%; walk by 24 months, 40%; and run, walk up stairs, and jump by 5 years, 45% to 52%. Conclusions: Children with DS require more time to learn movements as movement complexity increases. Impairment severity affected the rate but not the upper limit of motor function. The results have implications for counseling parents, making decisions about motor interventions, and anticipating the time frame for achievement of motor functions. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Participants

One hundred thirty-three children with DS, 1 month to 6 years of age, who were or had been clients of early intervention programs in southern Ontario, Canada, were enrolled in a study that examined the validity of the Gross Motor Function Measure (GMFM)23 for evaluating change in children with DS.24 The data from the initial GMFM assessment were further analyzed to meet the objectives of the present study. Informed consent of a parent or guardian was obtained for each subject. Ten subjects who

Results

The plots of the observed GMFM scores and the motor growth curve for children with mild motor impairment are in figure 1, and those for children with moderate or severe motor impairment are in figure 2.

. Gross motor function growth curve: children with mild motor impairment (n = 51). X, observed values; ●, predicted values nonlinear regression.

. Gross motor function growth curve: children with moderate or severe motor impairment (n = 70). X, observed values; ●, predicted values nonlinear regression.

Discussion

The relationship between age and gross motor function in children with DS during the first 6 years of life is represented by motor growth curves in which scores improve the fastest at younger ages, then level off as the predicted upper limit of gross motor function is approached. The difference rate and upper limit parameters for the curves suggest that motor impairment has a discernable effect on rate of improvement but only a slight effect on ultimate achievement of gross motor function

Conclusions

The present study contributes to the understanding of gross motor function of children with DS by providing evidence about the rate of improvement and upper limit of motor function during the first 6 years of life. The results indicate that children with DS require more time to learn movements as movement complexity increases and that, on average, children with DS did not completely achieve by the age of 6 years the motor abilities measured by the GMFM. The results should prove useful in

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  • Cited by (0)

    Supported by the Medical Research Council of Canada.

    ☆☆

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

    Reprint requests to Robert J. Palisano, ScD, MCP, Hahnemann University, Dept of Rehabilitation Sciences, MS 502, 245 N Broad St, Philadelphia, PA 19102-1192, e-mail: [email protected].

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