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Early Independent Wheeled Mobility in Children with Cerebral Palsy : A Norwegian Population-Based Registry Study

Kilde, Anne ; Evensen, Kari Anne I. ; Kløve, Nina ; Rodby-Bousquet, Elisabet LU orcid ; Lydersen, Stian and Klevberg, Gunvor Lilleholt (2025) In Journal of Clinical Medicine 14(3).
Abstract

Background: The aim was to explore independent wheeled mobility in children with CP, and identify predictors of early independent wheeled mobility and changes over time across birth cohorts. Methods: We included data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP) comprising 11,565 assessments of 1780 children born in 2002–2019. Variables included demographic data, Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels, wheelchair use, and independent wheeled mobility. Cox proportional hazard regression was used to identify predictors for early independent wheeled mobility. Kaplan–Meier survival curves were used to compare birth cohorts. Results: Of 769... (More)

Background: The aim was to explore independent wheeled mobility in children with CP, and identify predictors of early independent wheeled mobility and changes over time across birth cohorts. Methods: We included data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP) comprising 11,565 assessments of 1780 children born in 2002–2019. Variables included demographic data, Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels, wheelchair use, and independent wheeled mobility. Cox proportional hazard regression was used to identify predictors for early independent wheeled mobility. Kaplan–Meier survival curves were used to compare birth cohorts. Results: Of 769 (43%) children who used a wheelchair, 511 (67%) had independent wheeled mobility. Two thirds of the children (n = 337) achieved independent wheeled mobility before age 7. Most children with independent wheeled mobility used powered wheelchairs. Children at GMFCS levels III and IV were more likely to reach independent wheeled mobility at an early age. Children at MACS levels III–V had a lower probability of early independent wheeled mobility. The average age of achieving independent mobility decreased from 9.5 to 4.0 years between birth years 2002 and 2019. Conclusions: Two in three children were independent wheelchair users before 7 years of age, and the age of obtaining independent wheeled mobility has decreased over the last 20 years. Children with better hand function were more likely to obtain early independent wheeled mobility. Early intervention programs to promote mobility, development and participation should include powered mobility, adapted steering options, and interventions for hand function.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
assistive device, cerebral palsy, early intervention, independent mobility, powered mobility, wheelchair
in
Journal of Clinical Medicine
volume
14
issue
3
article number
923
publisher
MDPI AG
external identifiers
  • pmid:39941594
  • scopus:85217712205
ISSN
2077-0383
DOI
10.3390/jcm14030923
language
English
LU publication?
yes
id
3768845d-2db8-46e0-a5c1-98ff04ed3ecf
date added to LUP
2025-06-25 08:27:47
date last changed
2025-07-09 10:40:39
@article{3768845d-2db8-46e0-a5c1-98ff04ed3ecf,
  abstract     = {{<p>Background: The aim was to explore independent wheeled mobility in children with CP, and identify predictors of early independent wheeled mobility and changes over time across birth cohorts. Methods: We included data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP) comprising 11,565 assessments of 1780 children born in 2002–2019. Variables included demographic data, Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels, wheelchair use, and independent wheeled mobility. Cox proportional hazard regression was used to identify predictors for early independent wheeled mobility. Kaplan–Meier survival curves were used to compare birth cohorts. Results: Of 769 (43%) children who used a wheelchair, 511 (67%) had independent wheeled mobility. Two thirds of the children (n = 337) achieved independent wheeled mobility before age 7. Most children with independent wheeled mobility used powered wheelchairs. Children at GMFCS levels III and IV were more likely to reach independent wheeled mobility at an early age. Children at MACS levels III–V had a lower probability of early independent wheeled mobility. The average age of achieving independent mobility decreased from 9.5 to 4.0 years between birth years 2002 and 2019. Conclusions: Two in three children were independent wheelchair users before 7 years of age, and the age of obtaining independent wheeled mobility has decreased over the last 20 years. Children with better hand function were more likely to obtain early independent wheeled mobility. Early intervention programs to promote mobility, development and participation should include powered mobility, adapted steering options, and interventions for hand function.</p>}},
  author       = {{Kilde, Anne and Evensen, Kari Anne I. and Kløve, Nina and Rodby-Bousquet, Elisabet and Lydersen, Stian and Klevberg, Gunvor Lilleholt}},
  issn         = {{2077-0383}},
  keywords     = {{assistive device; cerebral palsy; early intervention; independent mobility; powered mobility; wheelchair}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of Clinical Medicine}},
  title        = {{Early Independent Wheeled Mobility in Children with Cerebral Palsy : A Norwegian Population-Based Registry Study}},
  url          = {{http://dx.doi.org/10.3390/jcm14030923}},
  doi          = {{10.3390/jcm14030923}},
  volume       = {{14}},
  year         = {{2025}},
}