Chih-Jou Lai1, Chung-Yao Chen2, Chia-Ling Chen3, Pei-Ying Sarah Chan4, I-Hsuan Shen5, Ching-Yi Wu6. 1. Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital and School of Medicine, No. 201, Sec.2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, Taiwan; National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, Taiwan 112, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: 1204milly@gmail.com. 2. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taiwan. Electronic address: jongyau@adm.cgmh.org.tw. 3. Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: clingchen@gmail.com. 4. Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital-Linkuo, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: chanp@mail.cgu.edu.tw. 5. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan; Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: shenih@mail.cgu.edu.tw. 6. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan; Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan. Electronic address: cywu@mail.cgu.edu.tw.
Abstract
BACKGROUND: When setting goals for cerebral palsy (CP) interventions, health-related quality of life (HRQoL) is an important outcome. AIMS: To compare longitudinal changes in HRQoL in children with CP of different levels of motor severity. METHODS AND PROCEDURES: Seventy-three children with CP were collected and classified into three groups based on Gross Motor Function Classification System (GMFCS) levels. HRQoL was assessed by parent's proxy of the TNO-AZL Preschool Quality of Life (TAPQOL) at baseline and 6 months later. OUTCOMES AND RESULTS: Children with GMFCS level V had a lower total TAPQOL score and scores in all domains than those with level I-IV (p<0.01), except for the non-motor subdomain of physical functioning at follow-up. With regards to longitudinal changes, the children with GMFCS level V had greater improvements in physical (p=0.016) and cognitive functioning (p=0.042), but greater deterioration in emotional functioning (p=0.008) than those with levels I-II at 6 months of follow-up. CONCLUSIONS AND IMPLICATIONS: Motor severity was associated with TAPQOL scores in all domains and changes in some domains in children with CP. Clinicians should early identify children at risk of a poor HRQoL and plan timely treatment strategies to enhance the HRQoL of children with CP.
BACKGROUND: When setting goals for cerebral palsy (CP) interventions, health-related quality of life (HRQoL) is an important outcome. AIMS: To compare longitudinal changes in HRQoL in children with CP of different levels of motor severity. METHODS AND PROCEDURES: Seventy-three children with CP were collected and classified into three groups based on Gross Motor Function Classification System (GMFCS) levels. HRQoL was assessed by parent's proxy of the TNO-AZL Preschool Quality of Life (TAPQOL) at baseline and 6 months later. OUTCOMES AND RESULTS:Children with GMFCS level V had a lower total TAPQOL score and scores in all domains than those with level I-IV (p<0.01), except for the non-motor subdomain of physical functioning at follow-up. With regards to longitudinal changes, the children with GMFCS level V had greater improvements in physical (p=0.016) and cognitive functioning (p=0.042), but greater deterioration in emotional functioning (p=0.008) than those with levels I-II at 6 months of follow-up. CONCLUSIONS AND IMPLICATIONS: Motor severity was associated with TAPQOL scores in all domains and changes in some domains in children with CP. Clinicians should early identify children at risk of a poor HRQoL and plan timely treatment strategies to enhance the HRQoL of children with CP.