Jun HIRATA

Kojika-en, Kochi Prefecture Institute for Handicapped Children

(Received 27 June 1996; accepted 29 November 1996)

Abstract: On 102 cases of cerebral palsy (73 spastic- and 29 athetosis-type cases who had acquired at least the motor function to crawl, the present author investigated the age of their attainment of motor milestones; rolling over, sitting, crawling and independent walking. Based on the results of this investigation, a comparative study on the progress of the locomotive functions was made according to ambulatory prognosis. On spastic type (diplegia, triplegia and quadriplegia) cases, most children who were able to sit at 18 months of age eventually walked independently or with crutch, while the children who were not able to sit by 30 months did not walk. Most children who achieved crawling by 24 months of age walked independently or with crutch, however most who failed to crawl before 36 months rarely walked. As for the period from the attainment of rolling to that of crawling, there was a significant statistical difference between the cases of independent walking and those of walking with crutch. Thirty four of 40 cases who walked independently became able to crawl within 12 months after acquisition of rolling. Nine of 14 cases who walked with support achieved this between 12 and 24 months after. None of the cases who did not walk achieved this within 12 months. Of athetosis type cases, a similar trend was observed to spastic type cases. The results confirmed that the period from the attainment of rolling to that of crawling is a signficant index of the ambulatory prediction in cerebral palsy.

Key words: cerebralpalsy, locomotion, prognosis, prediction, pediatric rehabilitation