Predictors of the development of disorders of body functions in children with cerebral palsy
Authors:   Federal Scientific and Educational Centre of Medial and Social Expertise and Rehabilitation named after G. A. Albreht, Saint-Petersburg, Russian Federation, Golovina Yu. A. , Mikhailishin V. V. ,   Federal Scientific and Educational Centre of Medial and Social Expertise and Rehabilitation named after G. A. Albreht, Saint-Petersburg, Russian Federation, Ponomarenko G. N. ,   Federal Scientific and Educational Centre of Medial and Social Expertise and Rehabilitation named after G. A. Albreht, Saint-Petersburg, Russian Federation; North-Western State Medical University named after I. I. Mechnikov, Saint-Petersburg, Russian Federation
Published: October 2024

Abstract. Among the diseases of the nervous system, cerebral palsy (cerebral palsy) is the most common cause of disability in children. Cerebralpalsy is characterized by disorders of statodynamic, mental, speech, sensory functions, as well as the presence of secondary complications due to changes in muscle tone and joint functions. The above functions are evaluated during a medical and social examination. To optimize the process of establishing the category of «disabled child» for children with cerebral palsy, it is relevant to identify predictors in determining the severity of persistent functional disorders as one of the criteria for establishing disability. The purpose of the work. To determine the predictors of the development of persistent functional disorders in children with cerebral palsy using discriminant analysis. Material and methods: The study used information from the acts and protocols of the medical and social examination of 1229 children with cerebral palsy, reflecting clinical, instrumental, psychophysical, integral indicators of the condition of patients. A correlation analysis was carried out to determine the relationship between integral health parameters and the severity of persistent disorders of body functions in order to select indicators for discriminant analysis. Using discriminant analysis, predictors of the development of persistent disorders of body functions in children with cerebral palsy were determined. Statistical significance was verified by means of a p-value with established significance levels of 0.05 to determine the significance of the correlation and 0.01 to select predictors based on the results of discriminant analysis. Results. According to the results of correlation and discriminant analysis, significant (p<0.01) predictors of the development of functional disorders included: assessment of the patient’s general condition on the GMFCS scale, lack of control of pelvic organ function, delayed psychomotor development in the first year of life, delayed speech development, the presence of pseudobulbar syndrome, the disease code according to ICD- 10. The accuracy of the created linear model was determined at the level of 0.92 in the task of classifying the severity of persistent disorders of body functions in children with cerebral palsy. Conclusion. The health indicators indicated in the results in children with cerebral palsy can be considered as significant predictors of the development of disorders of body functions. The developed classification model based on the selected predictors showed high accuracy (0.92) in the tasks of classifying the severity of persistent disorders of body functions in children with cerebral palsy.