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Stability of the gross motor function classification system in children with cerebral palsy in the two to four year age band

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JOURNAL OF PEDIATRIC REHABILITATION MEDICINE 2023年第2期16卷 321-329页

作者： Wizinsky, Amanda M. Donawerth, Molly Badgley, Megan Hemphill-Morytko, Brooke Laughlin, Emily Rogan, Marie Cincinnati Childrens Hosp Med Ctr Perlman Ctr Cincinnati OH USA Xavier Univ Cincinnati OH USA

PURPOSE: This study aimed to investigate the stability of the gross motor function classification system (GMFCS) in children with cerebral palsy (CP) in the two to four year age band, the frequency at which children were reclassified, and trends of reclassification to higher or lower ability. METHODS: This retrospective study included 164 children with CP between 24 to 48 months old with two or more GMFCS ratings at least 12 months apart between their second and fourth birthdays. GMFCS ratings were captured closest to 24, 36, and 48 months. Stability and reclassification trends were analyzed using inferential statistics. Frequency of reclassification, age at ratings, duration between ratings, and corresponding change rate were analyzed using descriptive statistics. RESULTS: When comparing ratings closest to second and fourth birthdays, a linear weighted kappa of 0.726 was found. Of the total population, 46.95% changed GMFCS levels at any time between two to four years of age, the majority of which were reclassified to a higher level of ability. CONCLUSION: Findings suggest the GMFCS is less stable in the two to four year age band compared to older age bands. Due to the importance of providing accurate guidance for caregivers and high rate of reclassification, it is recommended GMFCS levels be reassessed every six months during this period of time.

关键词： Cerebral palsy gross motor function classification system two to four year age band

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Introduction of the gross motor function classification system in Venezuela - a model for knowledge dissemination

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BMC PEDIATRICS 2015年第1期15卷 1-8页

作者： Lowing, Kristina Arredondo, Ynes C. Tedroff, Marika Tedroff, Kristina Karolinska Inst Karolinska Univ Hosp Dept Womens & Childrens Hlth SE-17176 Stockholm Sweden Child Rehabil Ctr Mundo Sonrisas Alta Vista Puerto Ordaz 8050 Venezuela

Background: A current worldwide common goal is to optimize the health and well-being of children with cerebral palsy (CP). In order to reach that goal, for this heterogeneous group, a common language and classification systems are required to predict development and offer evidence based interventions. In most countries in Africa, South America, Asia and Eastern Europe the classification systems for CP are unfamiliar and rarely used. Education and implementation are required. The specific aims of this study were to examine a model in order to introduce the gross motor function classification system (GMFCS-E&R) in Venezuela, and to examine the validity and the reliability. Methods: Children with CP, registered at a National child rehabilitation centre in Venezuela, were invited to participate. The Spanish version of GMFCS-E&R was used. The Wilson mobility scale was translated and used to examine the concurrent validity. A structured questionnaire, comprising aspects of mobility and gross motor function, was constructed. In addition, each child was filmed. A paediatrician in Venezuela received supervised self-education in GMFCS-E&R and the Wilson mobility scale. A Swedish student was educated in GMFCS-E&R and the Wilson mobility scale prior to visiting Venezuela. In Venezuela, all children were classified and scored by the paediatrician and student independently. An experienced paediatric physiotherapist (PT) in Sweden made independent GMFCS-E&R classifications and Wilson mobility scale scorings, accomplished through merging data from the structured questionnaire with observations of the films. Descriptive statistics were used and reliability was presented with weighted Kappa (Kw). Spearman's correlation coefficient was calculated to explore the concurrent validity between GMFCS-E&R and Wilson mobility scale. Results: Eighty-eight children (56 boys), mean age 10 years (3-18), with CP participated. The inter-rater reliability of GMFCS-E&R between;the paediatrician and t

关键词： Cerebral Palsy Structure Questionnaire Concurrent Validity Assistive Device gross motor function classification system

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Hospitalizations Following Complex Hip Surgery in Children with Intellectual Disability: A Self-Controlled Case Series Analysis

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JOURNAL OF PEDIATRICS 2025年 278卷 114435-114435页

作者： Anpalagan, Keerthi Jacoby, Peter Stannage, Katherine Leonard, Helen Langdon, Katherine Gibson, Noula Nagarajan, Lakshmi Wong, Kingsley Downs, Jenny Univ Western Australia Kids Res Inst Australia Ctr Child Hlth Res Perth Australia Perth Childrens Hosp Orthopaed Dept Perth Australia Perth Childrens Hosp Kids Rehab Perth Australia Perth Childrens Hosp Physiotherapy Dept Perth Australia UWA Perth Childrens Hosp Neurol Dept Perth Australia Curtin Univ Curtin Sch Allied Hlth Perth Australia

Objective To evaluate the associations between complex hip surgery and subsequent hospitalizations in children with intellectual disability, including a subset of children with cerebral palsy. Study design We conducted a retrospective cohort study using linked administrative, health, and disability data from Western Australia. Children born between 1983 and 2009 who underwent complex hip surgery by end 2014 were included (intellectual disability, n = 154;subset with cerebral palsy, n = 91). A self-controlled case series analysis using Poisson regression was used to estimate the age-adjusted associations of complex hip surgery on all- cause hospitalizations and when the principal diagnosis was lower respiratory tract infection or epilepsy, for periods following the individual's first major hip surgery, compared with the year before surgery. Results Age adjusted incidence of all-cause hospitalizations decreased after surgery (year 1: incidence rate ratio [IRR] 0.87 [95% CI, 0.74-1.02];year 6: IRR 0.57 [95% CI, 0.46-0.72]). The incidence of hospitalizations for lower respiratory tract infection increased (year 1: IRR, 1.03 [95% CI, 0.72-1.51];year 6: IRR 2.08 [95% CI, 1.18-3.68]). The incidence of hospitalizations for epilepsy decreased (year 1: IRR 0.93 [95% CI, 0.57, 1.54];year>6: IRR 0.72 [95% CI, 0.34-1.55]) after surgery. A similar pattern was observed for the subset of children with or without cerebral palsy. Conclusion Complex hip surgeries are associated with fewer hospitalizations overall but not respiratory hospitalizations for children with intellectual disability. Fewer hospitalizations suggest benefits for better musculoskeletal alignment. (J Pediatr 2025;278:114435).

关键词： data linkage intellectual disability database observational study cerebral palsy ACHI Australian classification of health intervention CP Cerebral palsy GMFCS gross motor function classification system ICD-10-AM International statistical classification of diseases and related health problems, tenth revision, Australian modification ICD-9-CM International classification of Disease, ninth revision ID Intellectual disability IDEA Intellectual Disability Exploring Answers IRR Incidence rate ratio LRTI Lower respiratory tract infection SCCS Self controlled case series WARDA Western Australian register of developmental anomalies

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Prediction of Neurodevelopmental Outcomes at 18 to 22 Months Using the Numerical Sarnat Score Compared with Modified Sarnat Staging in Infants with Moderate to Severe Hypoxic-Ischemic Encephalopathy

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JOURNAL OF PEDIATRICS 2025年 281卷 114522-114522页

作者： Natarajan, Girija McDonald, Scott A. Shankaran, Seetha Laptook, Abbot R. Bonifacio, Sonia Sewell, Elizabeth K. Chalak, Lina Cent Michigan Univ Discipline Pediat Mt Pleasant MI USA Wayne State Univ Dept Pediat Detroit MI USA RTI Int Dept Pediat Res Triangle Pk NC USA Brown Univ Dept Pediat Providence RI USA Stanford Univ Sch Med Dept Pediat Stanford CA USA Emory Univ Sch Med & Childrens Healthcare Atlanta Dept Pediat Div Neonatol Atlanta GA USA Univ Texas Southwestern Dept Pediat Div Neonatol Dallas TX USA Univ Texas Austin Austin TX USA Dell Childrens Hosp Austin TX USA

Objective To examine the association of a numerical Sarnat score (NSS) and modified Sarnat staging among newborn infants with moderate/severe hypoxic-ischemic encephalopathy and their neurodevelopmental outcomes at 18-22 months. Study design This secondary analysis included participants with gestational age >= 36 weeks and moderate/severe hypoxic-ischemic encephalopathy (HIE) from the Induced Hypothermia and Optimizing Cooling trials. Early (<6 hours age) neurologic examinations were performed by trained examiners to categorize HIE severity by modified Sarnat staging. The NSS was calculated by summing abnormal scores (2 for moderate, 3 for severe) in the 6 examination categories. The primary outcome was death or moderate/severe disability. Statistical analysis included logistic regression, adjusting for center, trial, and cooling group, and linear regression for continuous scales. Results The cohort (n = 528) included infants with 71% moderate and 29% severe HIE (37% Induced Hypothermia and 63% Optimizing Cooling participants). Median (IQR) NSS of infants with moderate and severe HIE were 11 (9-13) and 16 (16-17), respectively. There were significant associations among NSS, NSS tertiles, and modified Sarnat staging and death or disability, but there were no differences found in their area-under-the-curve estimates. Similar to modified Sarnat staging, NSS showed significant associations with Bayley-III cognitive, language, and motor scores and Bayley-II mental and psychomotor developmental indices. Conclusion Among infants with moderate or severe HIE, the NSS did not improve the predictive accuracy for death or disability at 18-22 months of age, compared with modified Sarnat staging performed in the initial 6 hours after birth by trained examiners.

关键词： hypoxic-ischemic encephalopathy Sarnat staging disability EEG Electroencephalogram GMFCS gross motor function classification system HIE Hypoxic-ischemic encephalopathy IH Induced Hypothermia MDI Mental Developmental Index MRI Magnetic resonance imaging NICHD National Institute of Child Health and Human Development NRN Neonatal Research Network NSS Numerical Sarnat score OC Optimizing Cooling PDI Psychomotor Developmental Index RCT Randomized controlled trial SIBEN Score of the Iberoamerican Society of Neonatology TH Therapeutic hypothermia TSS Total Sarnat score

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Maternal Diabetes and Neurodevelopmental Outcomes of Infants Born Before 29 Weeks' Gestation

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JOURNAL OF PEDIATRICS 2025年 276卷 114319-114319页

作者： Akinseye, Adetokunbo Pylypjuk, Christy Moddemann, Diane Afifi, Jehier Banihani, Rudaina Aziz, Khalid Wang, Dianna Seshia, Mary Univ Manitoba Max Rady Coll Med Dept Pediat & Child Hlth Sect Neonatol Winnipeg MB Canada Univ Manitoba Max Rady Coll Med Dept Obstet Gynecol & Reprod Sci Sect Maternal Fetal Med Winnipeg MB Canada Childrens Hosp Res Inst Manitoba Winnipeg MB Canada Univ Manitoba Max Rady Coll Med Dept Pediat & Child Hlth Winnipeg MB Canada Dalhousie Univ Dept Pediat Div Neonatal Perinatal Med Halifax NS Canada Univ Toronto Dept Pediat Toronto ON Canada Univ Alberta Dept Pediat Edmonton AB Canada

Objective To compare the neurodevelopmental outcomes of infants born at = 1 of Bayley-III scores = 1 of Bayley-III scores = 3, bilateral blindness, or need for hearing aids or cochlear implants). Secondary outcomes we... 详细信息

Objective To compare the neurodevelopmental outcomes of infants born at <29 weeks' gestation and exposed to diabetes in pregnancy with those unexposed. Study design This was a retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Infants born <29 weeks' gestation and admitted to a level 3 neonatal intensive care unit from 2009 through 2018 who had neurodevelopmental assessments at 18-24 months corrected age were eligible. The 2 primary outcomes were as follows: (1) Neurodevelopmental impairment (NDI) (>= 1 of Bayley-III scores < 85 in any domain, cerebral palsy, or vision or hearing impairment);and (2) significant NDI (sNDI) (>= 1 of Bayley-III scores < 70 in any domain, cerebral palsy gross motor function classification system >= 3, bilateral blindness, or need for hearing aids or cochlear implants). Secondary outcomes were the individual components of NDI and sNDI. Adjusted odds ratios with 95% CIs were calculated to determine outcomes between groups. Results Of 13 988 eligible infants, 55% attended neurodevelopmental follow-up assessments. Infants exposed to diabetes had increased odds of NDI compared with those unexposed (aOR 1.09 (95% CI 1.08-1.54);there was no difference in sNDI (aOR 1.07 (95% CI 0.84-1.36). Language and motor delays were more common in those exposed to maternal diabetes. Conclusions Higher rates of NDI, language, or motor delays were present in infants born at <29 weeks' gestation exposed to diabetes in utero. Future research is needed to determine the etiology and clinical significance of these findings.

关键词： maternal diabetes preterm neurodevelopmental outcomes aOR Adjusted odds ratio Bayley III Bayley Scales of Infant and Toddler Development Third Edition BPD Bronchopulmonary dysplasia CA Corrected age CI Confidence interval CNFUN Canadian Neonatal Follow-Up Network CNN Canadian Neonatal Network CP Cerebral palsy GA Gestational age GMFCS gross motor function classification system IQR Interquartile range LGA Large for gestational age NDI Neurodevelopmental impairment NEC Necrotizing enterocolitis NICU Neonatal intensive care unit ROP Retinopathy of prematurity SD Standard deviation SGA Small for gestational age SNAP-II Score for neonatal acute physiology-version 11 sNDI Significant neurodevelopmental impairment

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Psychometric Evaluation of the Persian Version of the functional Mobility Scale: Assessing Validity and Reliability

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PHYSICAL & OCCUPATIONAL THERAPY IN PEDIATRICS 2024年第5期44卷 721-732页

作者： Sadeghian Afarani, Razieh Fatorehchy, Saeid Rassafiani, Mehdi Vahedi, Mohsen Azadi, Hamidreza Akbarfahimi, Nazila Univ Social Welf & Rehabil Sci Fac Rehabil Sci Dept Occupat Therapy Tehran Iran Charles Sturt Univ Sch Allied Hlth Exercise & Sports Sci Bathurst Australia Univ Social Welf & Rehabil Sci Psychosis Res Ctr Dept Biostat & Epidemiol Tehran Iran Isfahan Univ Med Sci Dept Occupat Therapy Esfahan Iran Univ Social Welf & Rehabil Sci Rofeideh Rehabil Hosp Sch Rehabil Sci Dept Occupat Therapy Tehran Iran

AimThis study aimed to assess the content, concurrent validity, test-retest, and intra-rater reliability of the Persian version of the functional Mobility Scale (FMS) for evaluating functional mobility in children and adolescents with cerebral palsy (CP).MethodsFollowing international standards for measurement translation, we developed a Persian version of the FMS. A total of 160 participants took part in this study. Concurrent validity was assessed using Spearman's coefficient to correlate with the gross motor function classification system (GMFCS). Test-retest (n = 30) and intra-rater (n = 30) reliability of the FMS were also examined by Cohen's weighted kappa *** validity ranged from -0.912 to -0.941 for children and -0.912 to -0.936 for adolescents. Test-retest ranged from 0.902 to 1. Intra-rater ranged from 0.933 to *** Persian version of the FMS demonstrates very strong validity and almost perfect reliability for assessing and classifying functional mobility in children and adolescents with CP. These findings suggest that this tool could be a useful addition to clinical practice and research for the Persian-speaking population.

关键词： Cerebral palsy functional mobility scale gross motor function classification system measure reliability validity

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Cerebral Palsy and motor Impairment After Extreme Prematurity: Prediction of Diagnoses at Ages 2 and 10 Years

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JOURNAL OF PEDIATRICS 2024年 271卷 114037-114037页

作者： Marinelli, Timothy Yi, Joe X. O'Shea, T. Michael Joseph, Robert M. Hooper, Stephen R. Kuban, Karl C. K. Sakai, Christina Msall, Michael E. Fry, Rebecca Singh, Rachana Tufts Univ Sch Med Dept Pediat 800 Washington St Boston MA 02111 USA Univ North Carolina Chapel Hill Frank Porter Graham Child Dev Inst Chapel Hill NC USA Boston Univ Sch Med Dept Anat & Neurobiol Boston MA USA Boston Med Ctr Dept Pediat & Neurol Boston MA USA Massachusetts Gen Hosp Children Dept Pediat Boston MA USA Univ Chicago Pritzker Sch Med Kennedy Res Ctr Dept Pediat Chicago IL USA Univ Chicago Pritzker Sch Med Comer Childrens Hosp Chicago IL USA Univ N Carolina Gillings Sch Global Publ Hlth Dept Environm Sci & Engn Chapel Hill NC USA

Objective To identify perinatal factors in children born extremely preterm (EP) that were associated with motor impairment (MI) at 2 and 10 years of age and develop a predictive algorithm to estimate the risk of MI during childhood. Study design Participants of the Extremely Low Gestational Age Newborns Study (ELGANS) were classified as: no MI, MI only at 2 years, MI only at 10 years, and MI at both 2 and 10 years, based on a standardized neurological examination at 2 and the gross motor function classification system (GMFCS) at 10 years of age. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to develop the final predictive model. Results Of the 849 study participants, 64 (7.5%) had a diagnosis of MI at both 2 and 10 years and 63 (7.4%) had a diagnosis of MI at 1 visit but not the other. Of 22 total risk factors queried, 4 variables most reliably and accurately predicted MI: gestational age, weight z -score growth trajectory during neonatal intensive care unit (NICU) stay, ventriculomegaly, and cerebral echolucency on head ultrasound. By selecting probability thresholds of 3.5% and 7.0% at ages 2 and 10, respectively, likelihood of developing MI can be predicted with a sensitivity and specificity of 71.2%/72.1% at age 2 and 70.7%/70.7% at age 10. Conclusion In our cohort, the diagnosis of MI at 2 years did not always predict a diagnosis of MI at 10 years. Specific risk factors are predictive of MI and can estimate an individual infant's risk at NICU discharge of MI at age 10 years. (J Pediatr 2024;271:114037) .

关键词： cerebral palsy extremely preterm extremely low gestational age newborns gross motor function classification system motor impairment

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functional classification systems in Brazilian children with cerebral palsy: Reliability and associations between functional levels

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DEVELOPMENTAL NEUROREHABILITATION 2024年第7期27卷 243-250页

作者： Ayupe, Kennea Martins Almeida Lima, Amanda Larissa Oliveira Gomes, Gabrielly Cristine de Alcantara de Sousa, Deysiane Sobrinho Camargos, Ana Cristina Resende Chagas, Paula Silva de Carvalho Leite, Hercules Ribeiro Longo, Egmar de Toledo, Aline Martins Univ Brasilia Fac Ceilandia Sch Phys Therapy Bl ESQS 205 Brasilia DF Brazil Univ Brasilia Fac Ceilandia Grad Program Rehabil Sci Brasilia Brazil Univ Fed Minas Gerais Grad Program Rehabil Sci Belo Horizonte Brazil Univ Fed Juiz De Fora Sch Phys Therapy Grad Program Rehabil Sci & Phys & Funct Performanc Juiz De Fora Brazil Univ Fed Paraiba Grad Program Phys Therapy & Models Decis & Hlth Joao Pessoa Brazil

Children with Cerebral palsy (CP) present movement and posture disorders. The gross motor function classification system (GMFCS), Manual Ability classification system (MACS), Communication function classification system (CFCS), Eating and Drinking Ability classification system (EDACS), and Visual function classification system (VFCS) enhance the understanding of their performance. We verified inter-rater reliability and associations between the classification levels. Physical therapists classified 100 Brazilian children with CP (3-17 years) according to GMFCS, MACS, CFCS, EDACS, and VFCS. To evaluate inter-rater reliability (Intraclass Correlation Coefficient-ICC) two independent examiners concurrently assessed a subset of 60 participants. According to Spearman's correlation coefficients, there were associations between GMFCS/MACS (r = 0.81), GMFCS/CFCS (r = 0.70), MACS/CFCS (r = 0.73), GMFCS/VFCS (r = 0.61), MACS/VFCS (r = 0.61), CFCS/EDACS (r = 0.58), CFCS/VFCS (r = 0.50), and EDACS/VFCS (r = 0.45) (p < .05). The inter-rater reliability ranged from excellent (ICC = 0.93-0.99) to good (ICC = 0.89), p < .05. The classification systems are reliable, and the levels associated with each other in Brazilian children, especially the GMFCS, MACS, and CFCS.

关键词： Cerebral palsy communication function classification system eating and drinking ability classification system gross motor function classification system manual ability classification system

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Prevalence of Sensory Processing Deficits in Children with Spastic Cerebral Palsy - An Indian Caregiver's Perspective (Mar, 10.1007/s12098-024-05111-3, 2024)

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INDIAN JOURNAL OF PEDIATRICS 2024年第11期91卷 1221-1223页

作者： Dhiman, Sapna Goyal, Ramesh K. Mahesan, Aakash Ajmera, Puneeta Ganesh, G. Shankar Gulati, Sheffali Delhi Pharmaceut Sci & Res Univ Sch Physiotherapy New Delhi India Delhi Pharmaceut Sci & Res Univ Dept Pharmacol New Delhi India All India Inst Med Sci Ctr Excellence & Adv Res Childhood Neurodev Disord Dept Pediat Child Neurol Div New Delhi India Delhi Pharmaceut Sci & Res Univ Sch Allied Hlth Sci New Delhi India Composite Reg Ctr Persons Disabil Lucknow Uttar Pradesh India

This study aims to analyze the prevalence and patterns of sensory processing deficits (SPD) in Indian children with spastic cerebral palsy (CP) using child sensory profile-2 (CSP-2) caregiver questionnaire. The authors surveyed 230 caregivers of children aged 3 to 14 y with spastic CP, using CSP-2. The difference in prevalence and distribution of SPDs among the CP subtypes and gross motor function classification system (GMFCS) levels was done. Overall prevalence of “Definite” (>2 SD) SPDs was 83%. Forty-seven percent had definite SPDs in more than one sensory subsection. Prevalence of definite SPDs was similar among the spastic CP subtypes. “Conduct” domain had more affection among hemiplegics and quadriplegics. “Avoiding” pattern was observed more in quadriplegics and “Seeking” pattern was observed less in diplegics. Severe GMFCS levels had more definite sensory processing deficits. SPDs are highly prevalent in children with spastic CP with unique patterns of affection among the spastic CP subtypes.

关键词： Child sensory profile-2 gross motor function classification system Sensory processing deficits Spastic cerebral palsy

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Relationships of Severity of Bronchopulmonary Dysplasia with Adverse Neurodevelopmental Outcomes and Poor Respiratory function at 7-8 Years of Age

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JOURNAL OF PEDIATRICS 2024年 269卷 114005-114005页

作者： Doyle, Lex W. Ranganathan, Sarath Mainzer, Rheanna M. Cheong, Jeanie L. Y. Royal Womens Hosp Dept Obstet Gynaecol & Newborn Hlth Melbourne Vic Australia Univ Melbourne Dept Paediat Melbourne Australia Royal Womens Hosp Newborn Serv Melbourne Vic Australia Murdoch Childrens Res Inst Clin Sci Melbourne Australia Royal Childrens Hosp Dept Resp Med Melbourne Australia Murdoch Childrens Res Inst Clin Epidemiol & Biostat Melbourne Australia

Objective To clarify the relationships of 3 definitions of severity of bronchopulmonary dysplasia (BPD) with adverse neurodevelopmental and respiratory outcomes at early school-age. Study design Participants comprised 218 consecutive survivors to 7-8 years of age born either <28 weeks' gestation or weighing <1000 g in Victoria, Australia, in 2005. BPD was classified as none, grade 1 (mild), grade 2 (moderate), or grade 3 (severe), using 2 commonly accepted definitions: 1) Jobe2001, and 2) Higgins2018, and neurodevelopmental disability, low IQ and academic achievement, poor motor function, and poor respiratory function as assessed by spirometry. Outcomes for children with each grade of BPD were compared with children with no Results Of the 218 survivors, 132 (61%) had BPD on Jobe2001 criteria, and 113 (52%) had BPD on both Higgins2018 and VICS2005 criteria. Grade 1 on any criteria was not associated with any adverse neurodevelopmental outcomes. Grade 1 on both Higgins2018 and VICS2005 was associated with reduced spirometry, grade 2 on both Higgins2018 and VICS2005, and grade 3 on all criteria were associated with increased risk for both adverse neurodevelopmental and respiratory outcomes. Conclusions Compared with no BPD, receiving additional oxygen up to 29% but no positive pressure support at 36 weeks' postmenstrual age increased the risk of abnormal respiratory function but not adverse neurodevelopment. Receiving 330% oxygen or any positive pressure support at 36 weeks increased the risk of both adverse outcomes.

关键词： extremely preterm extremely low birthweight bronchopulmonary dysplasia neurodevelopment spirometry BPD Bronchopulmonary dysplasia CI Confidence interval ELBW Extremely low birth weight EP Extremely preterm FEF 25-75% Forced expiratory flow from 25% to 75% of vital capacity FEV 1 Forced expiratory volume in 1 second FiO 2 Fractional inspired oxygen concentration FVC Forced vital capacity GMFCS gross motor function classification system IPPV Intermittent positive pressure ventilation IQ Intelligence quotient MABC-2 Movement Assessment Battery for Children–Second Edition NA Not applicable NCPAP Nasal continuous positive airway pressure NIPPV Non-invasive intermittent positive pressure ventilation PMA Postmenstrual age RR Risk ratio SD Standard deviation VICS Victorian Infant Collaborative Study WRAT4 Wide Range Achievement Test–4th Edition

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