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Sit-to-stand performance in children with cerebral palsy : a population-based cross-sectional study

Romin, Elinor ; Lindgren, Anna LU ; Rodby-Bousquet, Elisabet LU and Cloodt, Erika LU (2024) In BMC Musculoskeletal Disorders 25(1).
Abstract

Background: Sit-to-stand (STS) is one of the most commonly performed functional movements in a child’s daily life that enables the child to perform functional activities such as independent transfer and to initiate walking and self-care. Children with cerebral palsy (CP) often have reduced STS ability. The aim of this study was to describe STS performance in a national based total population of children with CP and its association with age, sex, Gross Motor Function Classification System (GMFCS) level, and CP subtype. Methods: This cross-sectional study included 4,250 children (2,503 boys, 1,747 girls) aged 1–18 years from the Swedish Cerebral Palsy Follow-Up Program (CPUP). STS performance was classified depending on the independence... (More)

Background: Sit-to-stand (STS) is one of the most commonly performed functional movements in a child’s daily life that enables the child to perform functional activities such as independent transfer and to initiate walking and self-care. Children with cerebral palsy (CP) often have reduced STS ability. The aim of this study was to describe STS performance in a national based total population of children with CP and its association with age, sex, Gross Motor Function Classification System (GMFCS) level, and CP subtype. Methods: This cross-sectional study included 4,250 children (2,503 boys, 1,747 girls) aged 1–18 years from the Swedish Cerebral Palsy Follow-Up Program (CPUP). STS performance was classified depending on the independence or need for support into “without support,” “with support,” or “unable.” “With support” included external support from, e.g., walls and furniture. Physical assistance from another person was classified as “unable” (dependent). Ordinal and binary logistic regression analyses were used to identify associations between STS and age, GMFCS level, and CP subtype. Results: 60% of the children performed STS without support, 14% performed STS with support, and 26% were unable or needed assistance from another person. STS performance was strongly associated with GMFCS level and differed with age and subtype (p < 0.001). For all GMFCS levels, STS performance was lowest at age 1–3 years. Most children with GMFCS level I (99%) or II (88%) performed STS without support at the age of 4–6 years. In children with GMFCS level III or IV, the prevalence of independent STS performance improved throughout childhood. CP subtype was not associated with STS performance across all GMFCS levels when adjusted for age. Conclusions: Independent STS performance in children with CP is associated with GMFCS level and age. Children with CP acquire STS ability later than their peers normally do. The proportion of children with independent STS performance increased throughout childhood, also for children with GMFCS level III or IV. These findings suggest the importance of maintaining a focus on STS performance within physiotherapy strategies and interventions for children with CP, including those with higher GMFCS level.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, Children, Sit-to-stand
in
BMC Musculoskeletal Disorders
volume
25
issue
1
article number
460
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85195888134
  • pmid:38862936
ISSN
1471-2474
DOI
10.1186/s12891-024-07557-0
language
English
LU publication?
yes
id
cae7d417-38a1-4b4b-8c5f-7657ccbedce9
date added to LUP
2024-07-03 14:55:12
date last changed
2024-07-04 03:00:07
@article{cae7d417-38a1-4b4b-8c5f-7657ccbedce9,
  abstract     = {{<p>Background: Sit-to-stand (STS) is one of the most commonly performed functional movements in a child’s daily life that enables the child to perform functional activities such as independent transfer and to initiate walking and self-care. Children with cerebral palsy (CP) often have reduced STS ability. The aim of this study was to describe STS performance in a national based total population of children with CP and its association with age, sex, Gross Motor Function Classification System (GMFCS) level, and CP subtype. Methods: This cross-sectional study included 4,250 children (2,503 boys, 1,747 girls) aged 1–18 years from the Swedish Cerebral Palsy Follow-Up Program (CPUP). STS performance was classified depending on the independence or need for support into “without support,” “with support,” or “unable.” “With support” included external support from, e.g., walls and furniture. Physical assistance from another person was classified as “unable” (dependent). Ordinal and binary logistic regression analyses were used to identify associations between STS and age, GMFCS level, and CP subtype. Results: 60% of the children performed STS without support, 14% performed STS with support, and 26% were unable or needed assistance from another person. STS performance was strongly associated with GMFCS level and differed with age and subtype (p &lt; 0.001). For all GMFCS levels, STS performance was lowest at age 1–3 years. Most children with GMFCS level I (99%) or II (88%) performed STS without support at the age of 4–6 years. In children with GMFCS level III or IV, the prevalence of independent STS performance improved throughout childhood. CP subtype was not associated with STS performance across all GMFCS levels when adjusted for age. Conclusions: Independent STS performance in children with CP is associated with GMFCS level and age. Children with CP acquire STS ability later than their peers normally do. The proportion of children with independent STS performance increased throughout childhood, also for children with GMFCS level III or IV. These findings suggest the importance of maintaining a focus on STS performance within physiotherapy strategies and interventions for children with CP, including those with higher GMFCS level.</p>}},
  author       = {{Romin, Elinor and Lindgren, Anna and Rodby-Bousquet, Elisabet and Cloodt, Erika}},
  issn         = {{1471-2474}},
  keywords     = {{Cerebral palsy; Children; Sit-to-stand}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{Sit-to-stand performance in children with cerebral palsy : a population-based cross-sectional study}},
  url          = {{http://dx.doi.org/10.1186/s12891-024-07557-0}},
  doi          = {{10.1186/s12891-024-07557-0}},
  volume       = {{25}},
  year         = {{2024}},
}