新西兰奥特亚罗瓦学龄期及青年脑瘫儿童中可步行与非步行者的临床特征：对健康与教育衔接的启示
Clinical profiles of ambulatory and non-ambulatory school-aged children and young people with cerebral palsy in Aotearoa New Zealand: implications for the health education interface.
文献信息
| PMID | 42912972 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Karen Adams |
| 作者单位 | PhD Candidate, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand. |
| 期刊 | The New Zealand medical journal |
| SCI 分区 | Q2 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 在新西兰奥特亚罗瓦，步行能力会影响教育部——Te Tāhuhu o te Mātauranga对学龄期脑瘫儿童的治疗资助，但不同移动能力组之间的人口学和临床特征仍描述不足。本研究利用新西兰脑瘫登记处/Te Rēhita a Hōkai Nukurangi Aotearoa的数据，比较可步行与非步行的学龄期儿童，突出其不同的临床需求。
方法： 对1,149名5-21岁参与者进行了相关性、观察性分析。数据按粗大运动功能分类系统（GMFCS）I-III级以及GMFCS IV和V级分类，并使用卡方检验和单变量逻辑回归识别显著关联。
结果： 341名（29.7%）儿童被分类为GMFCS IV和V级。与GMFCS I-III级相比，被分类为GMFCS IV和V级者更可能患有癫痫（比值比[OR]=7.2 [5.2-10.0]）、双侧耳聋（OR=5.4 [2.6-11.4]）、中度或重度智力障碍（OR=21.9 [13.3-35.9]），并且更可能无言语能力（OR=89.1 [48.3-164.5]）或功能性失明（OR=63.4 [30.3-133.0]）（均为95%置信区间[95% CI]）。GMFCS水平与更高的手动能力分类系统、沟通功能分类系统和进食饮水能力分类系统水平相对应。
结论： 非步行脑瘫儿童具有更复杂的共病损害，这些损害超出身体限制，并且需要学校服务提供之外的支持。研究结果强调，在新西兰奥特亚罗瓦，资助和管理都需要采取全生命周期、跨学科的方法。
英文摘要
AIM: In Aotearoa New Zealand, ambulatory ability impacts Ministry of Education - Te Tāhuhu o te Mātauranga therapy funding for school-aged children with cerebral palsy, yet demographic and clinical profiles across mobility groups remain poorly described. This study utilises data from the New Zealand Cerebral Palsy Register/Te Rēhita a Hōkai Nukurangi Aotearoa to compare ambulatory and non-ambulatory school-aged children, highlighting their distinct clinical needs.
METHOD: A correlational, observational analysis of 1,149 participants aged 5-21 years was conducted. Data were categorised into Gross Motor Function Classification System (GMFCS) I-III, and GMFCS IV and V, with significant associations identified using Chi-squared tests and univariate logistic regression.
RESULTS: Three hundred and forty-one (29.7%) children were classified as GMFCS IV and V. Compared to GMFCS I-III, those classified as GMFCS IV and V were more likely to have epilepsy (odds ratio [OR]=7.2 [5.2-10.0]), bilateral deafness (OR=5.4 [2.6-11.4]), moderate or severe intellectual impairment (OR=21.9 [13.3-35.9]) and be non-verbal (OR=89.1 [48.3-164.5]) or functionally blind (OR=63.4 [30.3-133.0]) (all 95% confidence interval [95% CI]). GMFCS levels corresponded with higher Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System levels.
CONCLUSION: Non-ambulatory children with cerebral palsy have more complex, co-occurring impairments that extend beyond physical limitations and require support outside of school-based service provision. The findings underscore the need for whole-of-life, transdisciplinary approaches to both funding and management in Aotearoa New Zealand.