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Cerebral Palsy – The Adolescent Growth Evaluation Study (CP-AGE)

Background: Cerebral Palsy (CP) is the most common cause of long-term childhood disability. In Ireland, ~110 children with CP are born annually with approximately 70% being able to walk with or without aids. Some children with CP will experience a decline in walking related function through adolescence but the factors underpinning this are unknown.
Objective: To measure and explore factors associated with decline in walking during the adolescent growth spurt.
Methods: Participants will be assessed before their growth spurt, at intervals during the growth spurt and after the have gone through their peak growth phase. Pre-existing national and international databases comprising of clinical and walking measures (~ 16000 individuals) will be explored. A prospective longitudinal examination of walking related metrics will be completed in 120 young people with CP as they progress through peak adolescent growth. Baseline measures will be collected at age 10 (girls) and 11.5 (boys) with follow-up measures until completion of peak adolescent growth. Stakeholder focus groups will synthesise quantitative findings and devise key recommendations for practice/policy development. Within WP 1 and 2, repeat measures correlation will be used to determine interactions between walking decline and growth. Regression analysis will be used to determine the influence of measured outcome on ambulation trajectory. Focus group analysis will enable the synthesis of stakeholder views and priorities. A convergence analysis of secondary, prospective and focus group outputs across all domains of the International Classification of Functioning, Disability and Health (ICF) will be used to derive consensus recommendations for practice/policy enhancement,
Impact: The CP-AGE findings will enable stratified and targeted intervention and support systems to be deployed in individuals where risk of decline in ambulation is most acute. Key predictors of decline will be identified which will enable patient specific intervention algorithms to be devised according to risk of deterioration.