Table 5.
Linear regression models relating KIDSCREEN scores on each domain to type and level of impairment in adolescents with cerebral palsy (cross-sectional sample, n=431)
| Physical wellbeing | Psychological wellbeing | Moods and emotions | Self-perception | Autonomy | Relationships with parents | Social support and peers | School life | Financial resources | Social acceptance | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Initial models considering each impairment separately* | |||||||||||
| Gross Motor Function Classification System | |||||||||||
| I Walks and climbs stairs, without limitation | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| II Walks with limitations | −1·6 (−4·2 to 0·9) | −0·7 (−2·0 to 1·5) | −0·6 (−3·1 to 2·9) | −1·3 (−3·8 to 1·2) | −3·3 (−5·6 to −0·9)† | 0·7 (−1·6 to 3·1) | −3·0 (−6·2 to 0·0) | 0·0 (−2·4 to 2·3) | −0·9 (−3·6 to 1·9) | −1·0 (−3·6 to 1·5) | |
| III Walks with assistive devices | −2·5 (−5·5 to 0·6) | −0·5 (−3·6 to 2·5) | 0·7 (−2·2 to 3·6) | 0·3 (−2·6 to 3·3) | −3·9 (−6·6 to −1·0)† | 1·1 (−1·9 to 4·1) | −2·7 (−6·6 to 1·0) | 1·5 (−1·7 to 4·8) | −1·0 (−3·8 to 1·9) | 1·0 (−2·0 to 3·9) | |
| IV Unable to walk, limited self-mobility | −1·5 (−4·8 to 2·1) | 0·7 (−2·4 to 3·6) | −1·0 (−4·4 to 2·3) | −2·1 (−5·1 to 0·9) | −3·1 (−5·9 to −0·2)‡ | 1·2 (−1·7 to 4·1) | −4·9 (−8·7 to −1·3)† | 0·0 (−3·8 to 4·0) | 1·2 (−1·7 to 4·1) | −1·2 (−4·5 to 1·7) | |
| V Unable to walk, severely limited self-mobility | −3·0 (−7·1 to 1·0) | −1·2 (−4·5 to 2·2) | 0·1 (−3·5 to 3·9) | −0·4 (−4·0 to 3·2) | −3·4 (−7·1 to 0·4) | 1·9 (−1·0 to 4·9) | −7·5 (−12·6 to −2·7)† | −0·3 (−3·9 to 3·4) | 2·7 (−0·8 to 6·0) | 1·4 (−1·7 to 4·3) | |
| Bimanual Fine Motor Function | |||||||||||
| I Without limitation | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| II & III Moderate restrictions | −2·2 (−4·2 to −0·2)‡ | −1·3 (−3·1 to 0·5) | −1·3 (−3·2 to 0·6) | −1·8 (−3·7 to 0·1) | −2·4 (−4·3 to −0·5)‡ | 0·1 (−1·8 to 2·0) | −3·5 (−5·9 to −1·1)† | 1·0 (−1·0 to 3·0) | 0·3 (−1·7 to 2·2) | −0·3 (−2·3 to 1·7) | |
| IV & V Severe restrictions | −3·3 (−7·5 to 0·8) | −0·2 (−3·6 to 3·3) | 0·0 (−3·9 to 4·0) | −1·7 (−5·0 to 1·6) | −3·8 (−7·2 to −0·3)‡ | 1·0 (−2·2 to 4·1) | −5·6 (−11·3 to −1·4)† | −2·5 (−6·5 to 1·3) | 1·7 (−1·5 to 4·8) | 0·5 (−3·6 to 2·5) | |
| Seizures | |||||||||||
| No seizures (with or without medication) | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| Seizures | −1·6 (−4·8 to 1·7) | −1·0 (−4·1 to 2·1) | −5·3 (−8·2 to −2·3)† | 1·2 (−2·2 to 4·6) | 0·4 (−2·8 to 3·6) | −1·2 (−4·6 to 2·3) | −1·2 (−5·3 to 2·8) | 2·5 (−1·6 to 6·3) | 0·4 (−2·9 to 4·0) | −0·7 (−4·5 to 2·8) | |
| Feeding | |||||||||||
| No problems | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| Feeds orally with difficulty, or by tube | 0·2 (−3·7 to 4·0) | 0·7 (−2·5 to 3·9) | −1·1 (−5·0 to 3·0) | −0·5 (−3·8 to 2·8) | −1·1 (−4·9 to 2·5) | 0·1 (−3·3 to 3·4) | −5·8 (−11·1 to −1·0)‡ | −1·4 (−5·7 to 2·8) | 2·9 (−0·4 to 6·2) | 0·5 (−1·6 to 4·4) | |
| Intellectual impairment | |||||||||||
| IQ >70 | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| IQ ≤70 | −0·1 (−2·2 to 2·0) | 0·3 (−1·6 to 2·2) | −0·7 (−2·8 to 1·5) | 1·6 (−0·4 to 3·6) | −1·2 (−3·2 to 0·8) | −0·4 (−2·3 to 1·4) | −4·4 (−7·1 to −1·8)† | 0·3 (−1·9 to 2·4) | −1·6 (−3·7 to 0·4) | −2·0 (−4·1 to 0·0) | |
| Communication | |||||||||||
| Normal | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| Difficulties | −1·4 (−4·1 to 1·3) | −0·3 (−2·6 to 2·0) | −0·1 (−2·6 to 2·5) | −1·8 (−4·0 to 0·5) | −3·5 (−5·6 to −1·2)† | −1·5 (−3·7 to 0·8) | −4·7 (−7·5 to −2·0)† | −0·5 (−3·0 to 2·1) | −1·0 (−3·5 to 1·4) | −3·4 (−6·1 to −0·9)† | |
| Cerebral palsy type | |||||||||||
| Unilateral spastic | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | |
| Bilateral spastic | −0·9 (−3·0 to 1·3) | 1·0 (−1·0 to 2·9) | 0·5 (−1·5 to 2·6) | 0·5 (−1·5 to 2·5) | −0·9 (−2·9 to 1·0) | 1·9 (−0·0 to 3·8) | −1·9 (−4·3 to 0·7) | 1·1 (−1·1 to 3·2) | 0·2 (−1·9 to 2·30 | 0·7 (−1·3 to 2·7) | |
| Dyskinetic | 0·7 (−3·4 to 4·7) | 1·4 (−2·4 to 5·3) | −1·5 (−5·4 to 2·5) | −0·6 (−4·7 to 3·7) | −2·0 (−6·0 to 2·1) | 1·2 (−2·3 to 4·7) | −3·1 (−8·2 to 1·5) | −0·8 (−4·9 to 3·4) | 2·2 (−1·2 to 5·8) | −1·1 (−5·7 to 3·1) | |
| Ataxic | −1·5 (−6·6 to 3·9) | 1·7 (−2·3 to 6·2) | 1·0 (−3·5 to 5·7) | 2·9 (−2·4 to 9·1) | −2·9 (−8·0 to 2·8) | −0·3 (−5·2 to 5·2) | −4·5 (−14·2 to 6·2) | −0·3 (−5·8 to 6·2) | 1·2 (−5·3 to 7·6) | 5·2 (−0·1 to 9·5) | |
| Final models combining significant impairments* | |||||||||||
| Gross Motor Function Classification System | |||||||||||
| I Walks and climbs stairs, without limitation | .. | .. | .. | .. | 0·0 (reference) | .. | 0·0 (reference) | .. | .. | .. | |
| II, III, IV, V Limited walking ability or unable to walk | .. | .. | .. | .. | −3·4 (−5·2 to −1·6)† | .. | −3·5 (−5·8 to −1·1)† | .. | .. | .. | |
| Seizures | |||||||||||
| No seizures (with or without medication) | .. | .. | 0·0 (reference) | .. | .. | .. | .. | .. | .. | .. | |
| Seizures | .. | .. | −5·3 (−8·2 to −2·3)† | .. | .. | .. | .. | .. | .. | .. | |
| Intellectual impairment | |||||||||||
| IQ >70 | .. | .. | .. | .. | .. | .. | 0·0 (reference) | .. | .. | .. | |
| IQ ≤70 | .. | .. | .. | .. | .. | .. | −3·7 (−6·2 to −1·1)† | .. | .. | .. | |
| R2, % (95%CI) | .. | .. | 11% (5 to 19) | .. | 10% (4 to 18) | .. | 12% (6 to 18) | .. | .. | .. | |
Data are β coefficient (95% CI) unless otherwise stated.
*
Both initial and final models were adjusted for region, age, and sex. β coefficients show the average difference in quality of life between the relevant category and the reference category; β coefficients less than 0 show impaired quality of life. CIs were calculated by bootstrapping. Statistical significance:
†
99% CI excluding zero
‡
95% CI excluding zero.