Longitudinal changes in health-related quality of life in preschool children with cerebral palsy of different levels of motor severity

Background When setting goals for cerebral palsy (CP) interventions, health-related quality of life (HRQoL) is an important outcome. Aims To compare longitudinal changes in HRQoL in children with CP of different levels of motor severity. Methods and procedures Seventy-three children with CP were collected and classified into three groups based on Gross Motor Function Classification System (GMFCS) levels. HRQoL was assessed by parent's proxy of the TNO-AZL Preschool Quality of Life (TAPQOL) at baseline and 6 months later. Outcomes and results Children with GMFCS level V had a lower total TAPQOL score and scores in all domains than those with level I–IV (p < 0.01), except for the non-motor subdomain of physical functioning at follow-up. With regards to longitudinal changes, the children with GMFCS level V had greater improvements in physical (p = 0.016) and cognitive functioning (p = 0.042), but greater deterioration in emotional functioning (p = 0.008) than those with levels I–II at 6 months of follow-up. Conclusions and implications Motor severity was associated with TAPQOL scores in all domains and changes in some domains in children with CP. Clinicians should early identify children at risk of a poor HRQoL and plan timely treatment strategies to enhance the HRQoL of children with CP.