Motor functions in non-ambulatory children with spastic diplegia and periventricular leukomalacia

Abstract

The course of acquisition of various gross motor skills and changes in their patterns with advancing age, in addition to joint contracture, hand function, and mental ability, were investigated in 20 non-ambulatory children with spastic diplegia and periventricular leukomalacia. Among the diplegic children studied, those with lower locomotive ability also had lower hand function, lower mental ability and slower acquisition of gross motor skills. All subjects could roll by 24 months of age. Fourteen patients could creep by 18 months of age, and the remaining six by 30 months. Crawling was observed in only five patients with mild locomotive disability as a final locomotive pattern on the floor. Among ten patients with mild locomotive disability, three could sit by 2 years of age, six by 3 years, and one by 4 years. Among ten patients with severe disability, two, two, four and two children could sit at the ages of 2, 3, 4 and 5 years, respectively. Twelve patients could walk with support at between 2 and 5 years of age. Delay in acquisition of creeping or sitting differed somewhat among subjects with similar final locomotive disability. The majority of subjects with severe locomotive disability developed contracture of the hips and knees. Only two patients with mild disability had contracture of the ankles.