Causal factors affecting gross motor function in children diagnosed with cerebral palsy
<h4>Background</h4> Cerebral palsy (CP) is a complex neuromuscular condition that may negatively influence gross motor function. Children diagnosed with CP often exhibit spasticity, weakness, reduced motor control, contracture, and bony malalignment. Despite many previous association stu...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292109/?tool=EBI |
| _version_ | 1811288210069782528 |
|---|---|
| author | Bruce A. MacWilliams Sarada Prasad Amy L. Shuckra Michael H. Schwartz |
| author_facet | Bruce A. MacWilliams Sarada Prasad Amy L. Shuckra Michael H. Schwartz |
| author_sort | Bruce A. MacWilliams |
| collection | DOAJ |
| description | <h4>Background</h4> Cerebral palsy (CP) is a complex neuromuscular condition that may negatively influence gross motor function. Children diagnosed with CP often exhibit spasticity, weakness, reduced motor control, contracture, and bony malalignment. Despite many previous association studies, the causal impact of these impairments on motor function is unknown. <h4>Aim</h4> In this study, we proposed a causal model which estimated the effects of common impairments on motor function in children with spastic CP as measured by the 66-item Gross Motor Function Measure (GMFM-66). We estimated both direct and total effect sizes of all included variables using linear regression based on covariate adjustment sets implied by the minimally sufficient adjustment sets. In addition, we estimated bivariate effect sizes of all measures for comparison. <h4>Method</h4> We retrospectively evaluated 300 consecutive subjects with spastic cerebral palsy who underwent routine clinical gait analysis. Model data included standard information collected during this analysis. <h4>Results</h4> The largest causal effect sizes, as measured by standardized regression coefficients, were found for selective voluntary motor control and dynamic motor control, followed by strength, then gait deviations. In contrast, common treatment targets, such as spasticity and orthopedic deformity, had relatively small effects. Effect sizes estimated from bivariate models, which cannot appropriately adjust for other causal factors, substantially overestimated the total effect of spasticity, strength, and orthopedic deformity. <h4>Interpretation</h4> Understanding the effects of impairments on gross motor function will allow clinicians to direct treatments at those impairments with the greatest potential to influence gross motor function and provide realistic expectations of the anticipated changes. |
| first_indexed | 2024-04-13T03:32:00Z |
| format | Article |
| id | doaj.art-c515ff424f824f669ce6a2c94344a684 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T03:32:00Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c515ff424f824f669ce6a2c94344a6842022-12-22T03:04:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177Causal factors affecting gross motor function in children diagnosed with cerebral palsyBruce A. MacWilliamsSarada PrasadAmy L. ShuckraMichael H. Schwartz<h4>Background</h4> Cerebral palsy (CP) is a complex neuromuscular condition that may negatively influence gross motor function. Children diagnosed with CP often exhibit spasticity, weakness, reduced motor control, contracture, and bony malalignment. Despite many previous association studies, the causal impact of these impairments on motor function is unknown. <h4>Aim</h4> In this study, we proposed a causal model which estimated the effects of common impairments on motor function in children with spastic CP as measured by the 66-item Gross Motor Function Measure (GMFM-66). We estimated both direct and total effect sizes of all included variables using linear regression based on covariate adjustment sets implied by the minimally sufficient adjustment sets. In addition, we estimated bivariate effect sizes of all measures for comparison. <h4>Method</h4> We retrospectively evaluated 300 consecutive subjects with spastic cerebral palsy who underwent routine clinical gait analysis. Model data included standard information collected during this analysis. <h4>Results</h4> The largest causal effect sizes, as measured by standardized regression coefficients, were found for selective voluntary motor control and dynamic motor control, followed by strength, then gait deviations. In contrast, common treatment targets, such as spasticity and orthopedic deformity, had relatively small effects. Effect sizes estimated from bivariate models, which cannot appropriately adjust for other causal factors, substantially overestimated the total effect of spasticity, strength, and orthopedic deformity. <h4>Interpretation</h4> Understanding the effects of impairments on gross motor function will allow clinicians to direct treatments at those impairments with the greatest potential to influence gross motor function and provide realistic expectations of the anticipated changes.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292109/?tool=EBI |
| spellingShingle | Bruce A. MacWilliams Sarada Prasad Amy L. Shuckra Michael H. Schwartz Causal factors affecting gross motor function in children diagnosed with cerebral palsy PLoS ONE |
| title | Causal factors affecting gross motor function in children diagnosed with cerebral palsy |
| title_full | Causal factors affecting gross motor function in children diagnosed with cerebral palsy |
| title_fullStr | Causal factors affecting gross motor function in children diagnosed with cerebral palsy |
| title_full_unstemmed | Causal factors affecting gross motor function in children diagnosed with cerebral palsy |
| title_short | Causal factors affecting gross motor function in children diagnosed with cerebral palsy |
| title_sort | causal factors affecting gross motor function in children diagnosed with cerebral palsy |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292109/?tool=EBI |
| work_keys_str_mv | AT bruceamacwilliams causalfactorsaffectinggrossmotorfunctioninchildrendiagnosedwithcerebralpalsy AT saradaprasad causalfactorsaffectinggrossmotorfunctioninchildrendiagnosedwithcerebralpalsy AT amylshuckra causalfactorsaffectinggrossmotorfunctioninchildrendiagnosedwithcerebralpalsy AT michaelhschwartz causalfactorsaffectinggrossmotorfunctioninchildrendiagnosedwithcerebralpalsy |