Determining the Effective Factors on Prognosis of Gross Motor Function in Children with Cerebral Palsy Over Time by Marginal Modelling Method

Cerebral palsy (CP) is the most common chronic childhood disability with many mobility problems. The present study was conducted to determine the effective factors on prognosis of gross motor function. To measure the amount of mobility improvement in 60 CP patients with Gross Motor Function Classification System (GMFCS) 1-4, Gross Motor Function Measure (GMFM) was used. A longitudinal study was designed to determine the effective factors on obtaining the stages of GMFM by children with CP. They were referred to four centers in Shiraz, Fars Province, Southern Iran. Response to therapy (a dichotomous outcome (yes/no) was monitoring five times during six months for each participant, according to achievement to stages of GMFM and marginal modeling method was utilized. The results revealed the significance of some factors including age at starting occupational therapy services, number of sessions per week, type of spastic, level four of socioeconomic status (SES), grade two of GMFCS and time effe t on theoutcome (upgrade to a higher level on each occasion) (P<0.05). Based on the odds ratio (OR) values, the number of occupational therapy sessions per week had themost positive effect on gross motor function upgrade for at least two half times.Age at starting occupational therapy service was the second important factor inthe outcome. However, spending more time on therapy and early starting relate to family characteristics and also financial support.

کلیدواژه ها:

Cerebral palsy ، Gross motor function ، Longitudinal study ، Marginal model