{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T20:19:38Z","timestamp":1771013978978,"version":"3.50.1"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,7,1]]},"abstract":"<jats:p>Objective. The purpose of this study was to evaluate the relationship between cerebral palsy (CP) diagnoses as measured by the topographic distribution of the tone abnormality with level of function on the Gross Motor Function Classification System (GMFCS) and developmental performance on the Bayley Scales of Infant Development II (BSID-II). It was hypothesized that (1) the greater the number of limbs involved, the higher the GMFCS and the lower the BSID-II Motor Scores and (2) there would be a spectrum of function and skill achievement on the GMFCS and BSID-II Motor Scores for children in each of the CP categories.<\/jats:p><jats:p>Methods. A multicenter, longitudinal cohort study was conducted of 1860 extremely low birth weight (ELBW) infants who were born between August 1, 1995 and February 1, 1998, and evaluated at 18 to 22 months' corrected age. Children were categorized into impairment groups on the basis of the typography of neurologic findings: spastic quadriplegia, triplegia, diplegia, hemiplegia, monoplegia, hypotonic and\/or athetotic CP, other abnormal neurologic findings, and normal. The neurologic category then was compared with GMFCS level and BSID-II Motor Scores.<\/jats:p><jats:p>Results. A total of 282 (15.2%) of the 1860 children evaluated had CP. Children with more limbs involved had more abnormal GMFCS levels and lower BSID-II scores, reflecting more severe functional limitations. However, for each CP diagnostic category, there was a spectrum of gross motor functional levels and BSID-II scores. Although more than 1 (26.6%) in 4 of the children with CP had moderate to severe gross motor functional impairment, 1 (27.6%) in 4 had motor functional skills that allowed for ambulation.<\/jats:p><jats:p>Conclusions. Given the range of gross motor skill outcomes for specific types of CP, the GMFCS is a better indicator of gross motor functional impairment than the traditional categorization of CP that specifies the number of limbs with neurologic impairment. The neurodevelopmental assessment of young children is optimized by combining a standard neurologic examination with measures of gross and fine motor function (GMFCS and Bayley Psychomotor Developmental Index). Additional studies to examine longer term functional motor and adaptive-functional developmental skills are required to devise strategies that delineate therapies to optimize functional performance.<\/jats:p>","DOI":"10.1542\/peds.2004-1810","type":"journal-article","created":{"date-parts":[[2005,7,1]],"date-time":"2005-07-01T18:17:49Z","timestamp":1120241869000},"page":"123-129","source":"Crossref","is-referenced-by-count":69,"title":["Spectrum of Gross Motor Function in Extremely Low Birth Weight Children With Cerebral Palsy at 18 Months of Age"],"prefix":"10.1542","volume":"116","author":[{"given":"Betty R.","family":"Vohr","sequence":"first","affiliation":[{"name":"Women and Infants Hospital, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Msall","sequence":"additional","affiliation":[{"name":"University of Chicago Comer Children's and La Rabida Children's Hospitals, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dee","family":"Wilson","sequence":"additional","affiliation":[{"name":"Rainbow Babies and Children's Hospital, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda L.","family":"Wright","sequence":"additional","affiliation":[{"name":"National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McDonald","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Kenneth","family":"Poole","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2005,7,1]]},"reference":[{"key":"2021120905532651800_R1","doi-asserted-by":"crossref","unstructured":"Hagberg B, Hagberg G. The changing panorama of cerebral palsy\u2014bilateral spastic forms in particular. Acta Paediatr Suppl.\u20081996;416:48\u201352","DOI":"10.1111\/j.1651-2227.1996.tb14277.x"},{"key":"2021120905532651800_R2","doi-asserted-by":"crossref","unstructured":"Powell B, Hagberg G, Olow I. The changing panorama of cerebral palsy in Sweden, VI: prevalence and origin during the birth year period 1983\u20131986. Acta Paediatr.\u20081993;82:387\u2013393","DOI":"10.1111\/j.1651-2227.1993.tb12704.x"},{"key":"2021120905532651800_R3","doi-asserted-by":"crossref","unstructured":"Stanley F, Watson L. The cerebral palsies in western Australia: trends, 1968 to 1981. Am J Obstet Gynecol.\u20081988;158:89\u201393","DOI":"10.1016\/0002-9378(88)90784-3"},{"key":"2021120905532651800_R4","doi-asserted-by":"crossref","unstructured":"Piecuch RE, Leonard CH, Cooper BA, Kilpatrick SJ, Schlueter MA, Sola A. Outcome of infants born at 24\u201326 weeks' gestation: II. Neurodevelopmental outcome. Obstet Gynecol.\u20081997;90:809\u2013814","DOI":"10.1016\/S0029-7844(97)00429-8"},{"key":"2021120905532651800_R5","doi-asserted-by":"crossref","unstructured":"Surman G, Newdick H, Johnson A. Cerebral palsy rates among low-birthweight infants fell in the 1990s. Dev Med Child Neurol.\u20082003;45:456\u2013462","DOI":"10.1111\/j.1469-8749.2003.tb00940.x"},{"key":"2021120905532651800_R6","doi-asserted-by":"crossref","unstructured":"Pinto-Martin JA, Riolo S, Cnaan A, Holzman C, Susser MW, Paneth N. Cranial ultrasound prediction of disabling and nondisabling cerebral palsy at age two in a low birth weight population. Pediatrics.\u20081995;95:249\u2013254","DOI":"10.1542\/peds.95.2.249"},{"key":"2021120905532651800_R7","doi-asserted-by":"crossref","unstructured":"Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol.\u20082002;44:633\u2013640","DOI":"10.1111\/j.1469-8749.2002.tb00848.x"},{"key":"2021120905532651800_R8","doi-asserted-by":"crossref","unstructured":"Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993\u20131994. Pediatrics.\u20082000;105:1216\u20131226","DOI":"10.1542\/peds.105.6.1216"},{"key":"2021120905532651800_R9","doi-asserted-by":"crossref","unstructured":"Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol.\u20081997;39:214\u2013223","DOI":"10.1111\/j.1469-8749.1997.tb07414.x"},{"key":"2021120905532651800_R10","unstructured":"Bayley N. Bayley Scales of Infant Development-II. San Antonio, TX: Psychological Corporation; 1993"},{"key":"2021120905532651800_R11","doi-asserted-by":"crossref","unstructured":"Russell DJ, Rosenbaum PL, Cadman DT, Gowland C, Hardy S, Jarvis S. The gross motor function measure: a means to evaluate the effects of physical therapy. Dev Med Child Neurol.\u20081989;31:341\u2013352","DOI":"10.1111\/j.1469-8749.1989.tb04003.x"},{"key":"2021120905532651800_R12","unstructured":"Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ. Gross Motor Function Measure (GMFM-66 and GMFM-88) User's Manual. London, United Kingdom: Mackeith Press; 2002"},{"key":"2021120905532651800_R13","doi-asserted-by":"crossref","unstructured":"Russell DJ, Avery LM, Rosenbaum P, Raina PS, Walter SD, Palisano R. Improved scaling of the Gross Motor Function Measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther.\u20082000;80:873\u2013885","DOI":"10.1093\/ptj\/80.9.873"},{"key":"2021120905532651800_R14","unstructured":"Amiel-Tison C. Neuromotor status. In: Taeusch HW, Hogman MW, eds. Follow-up Management of the High-Risk Infant. Boston, MA: Little, Brown & Company; 1987:115\u2013126"},{"key":"2021120905532651800_R15","doi-asserted-by":"crossref","unstructured":"Evans P, Johnson A, Mutch L, Alberman E. Report of a meeting on the standardisation of the recording and reporting of cerebral palsy. Dev Med Child Neurol.\u20081986;28:547\u2013548","DOI":"10.1111\/j.1469-8749.1986.tb14304.x"},{"key":"2021120905532651800_R16","unstructured":"Folio MR, Fewell RR. Peabody Developmental Motor Scales and Activity Cards. Allen, TX: Developmental Learning Materials Resource; 1983"},{"key":"2021120905532651800_R17","unstructured":"Crothers B, Paine R. The Natural History of Cerebral Palsy. London, United Kingdom: Mackeith Press; 1998"},{"key":"2021120905532651800_R18","doi-asserted-by":"crossref","unstructured":"de Paz AC Jr, Burnett SM, Braga LW. Walking prognosis in cerebral palsy: a 22-year prospective analysis. Dev Med Child Neurol.\u20081994;36:130\u2013134","DOI":"10.1111\/j.1469-8749.1994.tb11821.x"},{"key":"2021120905532651800_R19","unstructured":"Molnar GE, Gordon SU. Cerebral palsy: predictive value of selected clinical signs for early prognostication of motor function. Arch Phys Med Rehabil.\u20081976;57:153\u2013158"},{"key":"2021120905532651800_R20","doi-asserted-by":"crossref","unstructured":"Msall ME, Tremont MR. Functional outcomes in self-care, mobility, communication, and learning in extremely low-birth weight infants. Clin Perinatol.\u20082000;27:381\u2013401","DOI":"10.1016\/S0095-5108(05)70027-0"},{"key":"2021120905532651800_R21","doi-asserted-by":"crossref","unstructured":"Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol.\u20082000;42:292\u2013296","DOI":"10.1017\/S0012162200000529"},{"key":"2021120905532651800_R22","doi-asserted-by":"crossref","unstructured":"Nordmark E, Jarnlo GB, Hagglund G. Comparison of the Gross Motor Function Measure and Paediatric Evaluation of Disability Inventory in assessing motor function in children undergoing selective dorsal rhizotomy. Dev Med Child Neurol.\u20082000;42:245\u2013252","DOI":"10.1017\/S0012162200000426"},{"key":"2021120905532651800_R23","doi-asserted-by":"crossref","unstructured":"Rosenbaum PL, Walter SD, Hanna SE, et al. Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA.\u20082002;288:1357\u20131363","DOI":"10.1001\/jama.288.11.1357"},{"key":"2021120905532651800_R24","doi-asserted-by":"crossref","unstructured":"O'Shea TM, Dammann O. Antecedents of cerebral palsy in very low-birth weight infants. Clin Perinatol.\u20082000;27:285\u2013302","DOI":"10.1016\/S0095-5108(05)70022-1"},{"key":"2021120905532651800_R25","doi-asserted-by":"crossref","unstructured":"Wheater M, Rennie JM. Perinatal infection is an important risk factor for cerebral palsy in very-low-birthweight infants. Dev Med Child Neurol.\u20082000;42:364\u2013367","DOI":"10.1017\/S0012162200000670"},{"key":"2021120905532651800_R26","unstructured":"Palta M, Sadek-Badawi M, Evans M, Weinstein MR, McGuinnes G. Functional assessment of a multicenter very low-birth-weight cohort at age 5 years. Newborn Lung Project. Arch Pediatr Adolesc Med.\u20082000;154:23\u201330"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/116\/1\/123\/1033684\/zpe00705000123.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/116\/1\/123\/1033684\/zpe00705000123.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T16:57:44Z","timestamp":1683133064000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/116\/1\/123\/72929\/Spectrum-of-Gross-Motor-Function-in-Extremely-Low"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,7,1]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2005,7,1]]},"published-print":{"date-parts":[[2005,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2004-1810","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,7,1]]}}}