![\"\"](\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2026\/10\/image-2.png\")
\n Patr\u00f3n de evoluci\u00f3n seg\u00fan nivel GMFCS<\/h3>\n\n\n\n\n - Niveles I y II (m\u00e1s leves):<\/strong> Sin declive funcional en la adolescencia.<\/li>\n
- Niveles III, IV y V (m\u00e1s severos):<\/strong> \n
\n - Pico de funci\u00f3n:<\/strong> 7 a\u00f1os 11 meses (nivel III), 6 a\u00f1os 11 meses (IV y V).<\/li>\n
- Declive posterior:<\/strong> P\u00e9rdida media de 4.7 puntos<\/strong> (nivel III), 7.8 puntos<\/strong> (IV) y 6.4 puntos<\/strong> (V) en GMFM-66 al alcanzar la edad adulta.<\/li>\n
- Relevancia cl\u00ednica:<\/strong> Estos descensos son cl\u00ednicamente significativos y requieren seguimiento activo.<\/li>\n <\/ul>\n <\/li>\n<\/ul>\n\n\n\n\n
M\u00e1s detalles sobre el estudio<\/summary>\n El modelo que permite declive funcional mejor ajusta los datos que el modelo de estabilidad. La p\u00e9rdida se observa principalmente en la adolescencia y j\u00f3venes adultos, especialmente en niveles m\u00e1s altos de GMFCS.<\/p>\n<\/details>\n\n\n\n
Estos hallazgos destacan la necesidad de reevaluar la funci\u00f3n motora en adolescentes con CP de niveles III a V, incluso tras alcanzar un pico funcional.<\/p>\n\n\n\n
Claves para la pr\u00e1ctica cl\u00ednica<\/h3>\n\n\n\n\n - El GMFM-66 debe ser monitoreado hasta la edad adulta en niveles III-V.<\/li>\n
- La aparici\u00f3n de declive funcional es esperable en niveles altos de CP, no debe considerarse patolog\u00eda nueva.<\/li>\n
- Intervenciones terap\u00e9uticas deben incluir estrategias de mantenimiento y prevenci\u00f3n de deterioro funcional.<\/li>\n<\/ul>\n\n\n\n\n\t\t19955111<\/span>\n\t\t{19955111:W4CXKLWZ}<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n <\/span>\n\t\t1<\/span>\n\t\tvancouver<\/span>\n\t\t50<\/span>\n\t\tdefault<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n <\/span>\n 8883<\/span>\n\t\thttps:\/\/neuropediatoolkit.org\/wp-content\/plugins\/zotpress\/<\/span>\n\n\t\t\n\t\t\t\n\t\t\t\t<\/span>%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22W4CXKLWZ%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Hanna%20et%20al.%22%2C%22parsedDate%22%3A%222009-04%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BHanna%20SE%2C%20Rosenbaum%20PL%2C%20Bartlett%20DJ%2C%20Palisano%20RJ%2C%20Walter%20SD%2C%20Avery%20L%2C%20et%20al.%20Stability%20and%20decline%20in%20gross%20motor%20function%20among%20children%20and%20youth%20with%20cerebral%20palsy%20aged%202%20to%2021%20years.%20Dev%20Med%20Child%20Neurol.%202009%20Apr%3B51%284%29%3A295%26%23x2013%3B302.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Stability%20and%20decline%20in%20gross%20motor%20function%20among%20children%20and%20youth%20with%20cerebral%20palsy%20aged%202%20to%2021%20years%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Steven%20E.%22%2C%22lastName%22%3A%22Hanna%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Peter%20L.%22%2C%22lastName%22%3A%22Rosenbaum%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Doreen%20J.%22%2C%22lastName%22%3A%22Bartlett%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Robert%20J.%22%2C%22lastName%22%3A%22Palisano%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Stephen%20D.%22%2C%22lastName%22%3A%22Walter%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Lisa%22%2C%22lastName%22%3A%22Avery%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Dianne%20J.%22%2C%22lastName%22%3A%22Russell%22%7D%5D%2C%22abstractNote%22%3A%22This%20paper%20reports%20the%20construction%20of%20gross%20motor%20development%20curves%20for%20children%20and%20youth%20with%20cerebral%20palsy%20%28CP%29%20in%20order%20to%20assess%20whether%20function%20is%20lost%20during%20adolescence.%20We%20followed%20children%20previously%20enrolled%20in%20a%20prospective%20longitudinal%20cohort%20study%20for%20an%20additional%204%20years%2C%20as%20they%20entered%20adolescence%20and%20young%20adulthood.%20The%20resulting%20longitudinal%20dataset%20comprised%203455%20observations%20of%20657%20children%20with%20CP%20%28369%20males%2C%20288%20females%29%2C%20assessed%20up%20to%2010%20times%2C%20at%20ages%20ranging%20from%2016%20months%20to%2021%20years.%20Motor%20function%20was%20assessed%20using%20the%2066-item%20Gross%20Motor%20Function%20Measure%20%28GMFM-66%29.%20Participants%20were%20classified%20using%20the%20Gross%20Motor%20Function%20Classification%20System%20%28GMFCS%29.%20We%20assessed%20the%20loss%20of%20function%20in%20adolescence%20by%20contrasting%20a%20model%20of%20function%20that%20assumes%20no%20loss%20with%20a%20model%20that%20allows%20for%20a%20peak%20and%20subsequent%20decline.%20We%20found%20no%20evidence%20of%20functional%20decline%2C%20on%20average%2C%20for%20children%20in%20GMFCS%20Levels%20I%20and%20II.%20However%2C%20in%20Levels%20III%2C%20IV%2C%20and%20V%2C%20average%20GMFM-66%20was%20estimated%20to%20peak%20at%20ages%207%20years%2011%20months%2C%206%20years%2011%20months%2C%20and%206%20years%2011%20months%20respectively%2C%20before%20declining%20by%204.7%2C%207.8%2C%20and%206.4%20GMFM-66%20points%2C%20in%20Levels%20III%2C%20IV%2C%20and%20V%20respectively%2C%20as%20these%20adolescents%20became%20young%20adults.%20We%20show%20that%20these%20declines%20are%20clinically%20significant.%22%2C%22date%22%3A%222009-04%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1111%5C%2Fj.1469-8749.2008.03196.x%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22%22%2C%22PMID%22%3A%2219391185%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%221469-8749%22%2C%22language%22%3A%22eng%22%2C%22collections%22%3A%5B%227L3LPGBN%22%5D%2C%22dateModified%22%3A%222026-10-25T18%3A59%3A34Z%22%7D%7D%5D%7D<\/span>\n\n\t\t\t\t\n\n \n 1.<\/div>Hanna SE, Rosenbaum PL, Bartlett DJ, Palisano RJ, Walter SD, Avery L, et al. Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years. Dev Med Child Neurol. 2009 Apr;51(4):295\u2013302.<\/div>\n <\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>","protected":false},"excerpt":{"rendered":"
Historia natural de la PCI seg\u00fan GMFCS: evoluci\u00f3n del motor en CP Este an\u00e1lisis se basa en un estudio longitudinal de ni\u00f1os con par\u00e1lisis cerebral (PCI) que eval\u00faa el desarrollo y estabilidad funcional mediante el GMFM-66 y la clasificaci\u00f3n GMFCS. Estudio clave: Hanna et al., DMCN 2008 Estudio prospectivo longitudinal con 657 participantes (16 meses … <\/p>\n
- \n
- Pico de funci\u00f3n:<\/strong> 7 a\u00f1os 11 meses (nivel III), 6 a\u00f1os 11 meses (IV y V).<\/li>\n
- Declive posterior:<\/strong> P\u00e9rdida media de 4.7 puntos<\/strong> (nivel III), 7.8 puntos<\/strong> (IV) y 6.4 puntos<\/strong> (V) en GMFM-66 al alcanzar la edad adulta.<\/li>\n
- Relevancia cl\u00ednica:<\/strong> Estos descensos son cl\u00ednicamente significativos y requieren seguimiento activo.<\/li>\n <\/ul>\n <\/li>\n<\/ul>\n\n\n\n
\nM\u00e1s detalles sobre el estudio<\/summary>\n
El modelo que permite declive funcional mejor ajusta los datos que el modelo de estabilidad. La p\u00e9rdida se observa principalmente en la adolescencia y j\u00f3venes adultos, especialmente en niveles m\u00e1s altos de GMFCS.<\/p>\n<\/details>\n\n\n\n
Estos hallazgos destacan la necesidad de reevaluar la funci\u00f3n motora en adolescentes con CP de niveles III a V, incluso tras alcanzar un pico funcional.<\/p>\n\n\n\n
Claves para la pr\u00e1ctica cl\u00ednica<\/h3>\n\n\n\n
- \n
- El GMFM-66 debe ser monitoreado hasta la edad adulta en niveles III-V.<\/li>\n
- La aparici\u00f3n de declive funcional es esperable en niveles altos de CP, no debe considerarse patolog\u00eda nueva.<\/li>\n
- Intervenciones terap\u00e9uticas deben incluir estrategias de mantenimiento y prevenci\u00f3n de deterioro funcional.<\/li>\n<\/ul>\n\n\n\n\n\t\t19955111<\/span>\n\t\t{19955111:W4CXKLWZ}<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n <\/span>\n\t\t1<\/span>\n\t\tvancouver<\/span>\n\t\t50<\/span>\n\t\tdefault<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n\t\t<\/span>\n <\/span>\n 8883<\/span>\n\t\thttps:\/\/neuropediatoolkit.org\/wp-content\/plugins\/zotpress\/<\/span>\n\n\t\t\n\t\t\t\n\t\t\t\t<\/span>%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22W4CXKLWZ%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Hanna%20et%20al.%22%2C%22parsedDate%22%3A%222009-04%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BHanna%20SE%2C%20Rosenbaum%20PL%2C%20Bartlett%20DJ%2C%20Palisano%20RJ%2C%20Walter%20SD%2C%20Avery%20L%2C%20et%20al.%20Stability%20and%20decline%20in%20gross%20motor%20function%20among%20children%20and%20youth%20with%20cerebral%20palsy%20aged%202%20to%2021%20years.%20Dev%20Med%20Child%20Neurol.%202009%20Apr%3B51%284%29%3A295%26%23x2013%3B302.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Stability%20and%20decline%20in%20gross%20motor%20function%20among%20children%20and%20youth%20with%20cerebral%20palsy%20aged%202%20to%2021%20years%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Steven%20E.%22%2C%22lastName%22%3A%22Hanna%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Peter%20L.%22%2C%22lastName%22%3A%22Rosenbaum%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Doreen%20J.%22%2C%22lastName%22%3A%22Bartlett%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Robert%20J.%22%2C%22lastName%22%3A%22Palisano%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Stephen%20D.%22%2C%22lastName%22%3A%22Walter%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Lisa%22%2C%22lastName%22%3A%22Avery%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Dianne%20J.%22%2C%22lastName%22%3A%22Russell%22%7D%5D%2C%22abstractNote%22%3A%22This%20paper%20reports%20the%20construction%20of%20gross%20motor%20development%20curves%20for%20children%20and%20youth%20with%20cerebral%20palsy%20%28CP%29%20in%20order%20to%20assess%20whether%20function%20is%20lost%20during%20adolescence.%20We%20followed%20children%20previously%20enrolled%20in%20a%20prospective%20longitudinal%20cohort%20study%20for%20an%20additional%204%20years%2C%20as%20they%20entered%20adolescence%20and%20young%20adulthood.%20The%20resulting%20longitudinal%20dataset%20comprised%203455%20observations%20of%20657%20children%20with%20CP%20%28369%20males%2C%20288%20females%29%2C%20assessed%20up%20to%2010%20times%2C%20at%20ages%20ranging%20from%2016%20months%20to%2021%20years.%20Motor%20function%20was%20assessed%20using%20the%2066-item%20Gross%20Motor%20Function%20Measure%20%28GMFM-66%29.%20Participants%20were%20classified%20using%20the%20Gross%20Motor%20Function%20Classification%20System%20%28GMFCS%29.%20We%20assessed%20the%20loss%20of%20function%20in%20adolescence%20by%20contrasting%20a%20model%20of%20function%20that%20assumes%20no%20loss%20with%20a%20model%20that%20allows%20for%20a%20peak%20and%20subsequent%20decline.%20We%20found%20no%20evidence%20of%20functional%20decline%2C%20on%20average%2C%20for%20children%20in%20GMFCS%20Levels%20I%20and%20II.%20However%2C%20in%20Levels%20III%2C%20IV%2C%20and%20V%2C%20average%20GMFM-66%20was%20estimated%20to%20peak%20at%20ages%207%20years%2011%20months%2C%206%20years%2011%20months%2C%20and%206%20years%2011%20months%20respectively%2C%20before%20declining%20by%204.7%2C%207.8%2C%20and%206.4%20GMFM-66%20points%2C%20in%20Levels%20III%2C%20IV%2C%20and%20V%20respectively%2C%20as%20these%20adolescents%20became%20young%20adults.%20We%20show%20that%20these%20declines%20are%20clinically%20significant.%22%2C%22date%22%3A%222009-04%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1111%5C%2Fj.1469-8749.2008.03196.x%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22%22%2C%22PMID%22%3A%2219391185%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%221469-8749%22%2C%22language%22%3A%22eng%22%2C%22collections%22%3A%5B%227L3LPGBN%22%5D%2C%22dateModified%22%3A%222026-10-25T18%3A59%3A34Z%22%7D%7D%5D%7D<\/span>\n\n\t\t\t\t\n\n\n1.<\/div>Hanna SE, Rosenbaum PL, Bartlett DJ, Palisano RJ, Walter SD, Avery L, et al. Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years. Dev Med Child Neurol. 2009 Apr;51(4):295\u2013302.<\/div>\n <\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>","protected":false},"excerpt":{"rendered":"
Historia natural de la PCI seg\u00fan GMFCS: evoluci\u00f3n del motor en CP Este an\u00e1lisis se basa en un estudio longitudinal de ni\u00f1os con par\u00e1lisis cerebral (PCI) que eval\u00faa el desarrollo y estabilidad funcional mediante el GMFM-66 y la clasificaci\u00f3n GMFCS. Estudio clave: Hanna et al., DMCN 2008 Estudio prospectivo longitudinal con 657 participantes (16 meses … <\/p>\n
- Declive posterior:<\/strong> P\u00e9rdida media de 4.7 puntos<\/strong> (nivel III), 7.8 puntos<\/strong> (IV) y 6.4 puntos<\/strong> (V) en GMFM-66 al alcanzar la edad adulta.<\/li>\n