Predicting the age of independent walking for children with cerebral palsy
10.3760/cma.j.issn.0254-1424.2023.10.012
- VernacularTitle:脑性瘫痪儿童独立行走年龄预后的列线图预测模型研究
- Author:
Yonghui YANG
1
;
Huachun XIONG
;
Junying YUAN
;
Dengna ZHU
;
Yiwen WANG
Author Information
1. 郑州大学第三附属医院儿童康复科，郑州 450052
- Keywords:
Cerebral palsy;
Independent walking;
Prediction models
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2023;45(10):922-927
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish and validate a model predicting the age at which a child with cerebral palsy will be able to walk independently.Methods:Data spanning 2016 to 2020 were collected from the cerebral palsy registration platform to build a database. Then, 70% of the patients were randomly assigned to the modeling group, while the remaining 30% were reserved for validation. Factors such as gender, bilirubin encephalopathy, neonatal asphyxia, extremely low birth weight, early pre-term birth, cerebral palsy type, magnetic resonance classification, gross motor function classification (GMFCS) score before 2 years of age, independent sitting age, ability to sit independently at 2 years of age, sections A through E of the gross motor function measure (GMFM-88), epilepsy, intellectual disability, visual impairment and surgery were analyzed applying Cox univariate regression analysis. The variables highlighted by the univariate regression analysis were included in Cox multivariate regression analyses, and a prediction model for the independent walking of children with cerebral palsy was established. It is presented as a linear graph. The C-statistic and calibration curve were used to evaluate the graph′s discrimination ability and calibration. Net reclassification improvement (NRI) was used to evaluate the linear graph′s net benefit.Results:A total of 807 cases were included in the study, with 565 and 242 in the model and validation groups, respectively. GMFCS score before 2 years of age, cerebral palsy type, independent sitting age, intellectual disability and early pre-term birth were found to be independent predictors of the age of independent walking. The C-statistics for 1-6 year-olds were all >0.8, indicating that the prediction model had good discrimination. The calibration curve showed that the predicted probability of independent walking at 1-4 years old was consistent with the observed probability, while the predicted probability of independent walking at 5-6 years old was higher than the observed probability. NRI suggested that the net benefit of the linear graph prediction model was not less than that of the full-factor model.Conclusion:A linear model was developed which can usefully predict the age of independent walking for children with cerebral palsy.
