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 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.

The dataset contains of the following files:
- Functional_development_in Uganda_dataset_Andrews_et_al.csv
- Variable_list_for_functional_development_in_Uganda_dataset_Andrews_et_al.pdf

Information about the tool Gross Motor Function Measure-66 (GMFM-66):
https://www.canchild.ca/en/resources/44-gross-motor-function-measure-gmfm