Functional development in children and youth with cerebral palsy in Uganda

AIM
To follow the functional development of a population-based cohort of children and youth (C&Y) with cerebral palsy (CP) in rural Uganda and compare their development with developmental trajectories from high-income countries (HIC).

METHODS
Eighty-one C&Y aged 2–17 years with CP were assessed 2015 and 2019 using Gross Motor Function Measure-66 items (GMFM-66), Pediatric Evaluation of Disability Inventory, Ugandan version (PEDI-UG), and functional classification systems. We calculated scaled scores (actual scores) and reference scores (amount of deviation from HIC developmental trajectories). Wilcoxon signed rank test was used for statistical analyses.

RESULTS
C&Y with CP in Uganda exhibited no differences in scaled scores between the first and second assessments for GMFM-66 and PEDI-UG mobility skills, while they exhibited increased PEDI-UG self-care skills (p<0.001). Reference scores were more negative at the second assessment than at the first assessment for GMFM-66 (p=0.002) and PEDI-UG mobility (p=0.036) but not for PEDI-UG self-care. The increased difference in reference scores ove

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AIM
To follow the functional development of a population-based cohort of children and youth (C&Y) with cerebral palsy (CP) in rural Uganda and compare their development with developmental trajectories from high-income countries (HIC).

METHODS
Eighty-one C&Y aged 2–17 years with CP were assessed 2015 and 2019 using Gross Motor Function Measure-66 items (GMFM-66), Pediatric Evaluation of Disability Inventory, Ugandan version (PEDI-UG), and functional classification systems. We calculated scaled scores (actual scores) and reference scores (amount of deviation from HIC developmental trajectories). Wilcoxon signed rank test was used for statistical analyses.

RESULTS
C&Y with CP in Uganda exhibited no differences in scaled scores between the first and second assessments for GMFM-66 and PEDI-UG mobility skills, while they exhibited increased PEDI-UG self-care skills (p<0.001). Reference scores were more negative at the second assessment than at the first assessment for GMFM-66 (p=0.002) and PEDI-UG mobility (p=0.036) but not for PEDI-UG self-care. The increased difference in reference scores over the 4 years were primarily driven by younger children (2–5 years) and C&Y with milder impairments.

INTERPRETATION
The increased difference in reference scores between assessments suggests that C&Y with CP in Uganda develop motor skills at a lower rate than peers in HIC. Show less..