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Tytuł:
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Trajectories of Motor Recovery in the First Year After Pediatric Arterial Ischemic Stroke.
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Autorzy:
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Cooper AN; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.
Anderson V; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.; The Royal Children's Hospital, Melbourne, Victoria, Australia.
Hearps S; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.
Greenham M; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.
Ditchfield M; Monash Medical Centre, Southern Health, Melbourne, Victoria, Australia.; Monash University, Melbourne, Victoria, Australia.
Coleman L; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; The Royal Children's Hospital, Melbourne, Victoria, Australia.
Hunt RW; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.; The Royal Children's Hospital, Melbourne, Victoria, Australia.
Mackay MT; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.; The Royal Children's Hospital, Melbourne, Victoria, Australia.
Monagle P; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.; The Royal Children's Hospital, Melbourne, Victoria, Australia.
Gordon AL; Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; and .; Kings College London, London, United Kingdom.
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Źródło:
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Pediatrics [Pediatrics] 2017 Aug; Vol. 140 (2). Date of Electronic Publication: 2017 Jul 14.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Elk Grove Village Il : American Academy of Pediatrics
Original Publication: Springfield, Ill., Thomas.
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MeSH Terms:
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Cerebral Infarction/*diagnosis
Hypoxia-Ischemia, Brain/*diagnosis
Motor Disorders/*diagnosis
Acute Disease ; Adaptation, Psychological ; Adolescent ; Child ; Child, Preschool ; Disability Evaluation ; Dominance, Cerebral ; Female ; Hemiplegia/diagnosis ; Humans ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Mobility Limitation ; Neurologic Examination ; Prospective Studies ; Recovery of Function ; Surveys and Questionnaires ; Victoria
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Entry Date(s):
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Date Created: 20170716 Date Completed: 20170828 Latest Revision: 20170828
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Update Code:
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20240105
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DOI:
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10.1542/peds.2016-3870
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PMID:
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28710246
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Background: Neuromotor impairments are common after pediatric stroke, but little is known about functional motor outcomes. We evaluated motor function and how it changed over the first 12 months after diagnosis. We also examined differences in outcome according to age at diagnosis and whether fine motor (FM) or gross motor (GM) function at 12 months was associated with adaptive behavior.
Methods: This prospective, longitudinal study recruited children ( N = 64) from The Royal Children's Hospital, Melbourne who were diagnosed with acute arterial ischemic stroke (AIS) between December 2007 and November 2013. Motor assessments were completed at 3 time points after the diagnosis of AIS (1, 6, and 12 months). Children were grouped as follows: neonates ( n = 27), preschool-aged ( n = 19), and school-aged ( n = 18).
Results: A larger lesion size was associated with poorer GM outcomes at 12 months ( P = .016). Neonatal AIS was associated with better FM and GM function initially but with a reduction in z scores over time. For the preschool- and school-aged groups, FM remained relatively stable over time. For GM outcomes, the preschool- and the school-aged age groups displayed similar profiles, with gradual recovery over time. Overall, poor FM and GM outcomes at 12 months were associated with poorer adaptive behavior scores.
Conclusions: Motor outcomes and the trajectory of recovery post-AIS differed according to a child's age at stroke onset. These findings indicate that an individualized approach to surveillance and intervention may be needed that is informed in part by age at diagnosis.
Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
(Copyright © 2017 by the American Academy of Pediatrics.)
