Longitudinal cohort protocol study of children with cerebral palsy in China: functional developmental trends, genetic etiology and imaging features of brain

Longitudinal cohort protocol study of children with cerebral palsy in China: functional developmental trends, genetic etiology and imaging features of brain | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol Longitudinal cohort protocol study of children with cerebral palsy in China: functional developmental trends, genetic etiology and imaging features of brain Tingting Peng, Tingting Peng, Jinling Li, Zhaoyao He, Jie Luo, and 20 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3996459/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Cerebral palsy (CP) is the most common physical disability in children, which brings heavy economic and mental burden to families and society. Nowadays, the clinical management of CP faces with huge challenge due to the unsatisfactory therapeutic effects and the enormous heterogeneity in etiology and clinical manifestations. This study aims to investigate the functional changes and the influential factors of Chinese children with CP, and elucidate the characteristic of brain structure and genetic etiology, thus to provide solutions for the prevention and treatment of children with CP and the decision-making of health management in this group. Methods and analysis: This prospective cohort study aims to recruit 1547 children with CP in China. Participants will receive basic information investigation (such as birth history, family history and comorbidities), functional assessments (gross and fine motor function, cognitive and linguistic function, quality of life, social life ability, eating and drinking ability, behavior problems, sleep, pain and nutritional status) and regular follow-ups, whole-genome analysis, brain and musculoskeletal imaging examination. In addition, quality of life and emotional problems will be analysed for caregivers. Correlation analysis, logistic regression binary or multivariate logistic regression, linear/non-linear mixed-effects regression models and structural-equation models will be conducted in this study. Discussion: This study will observe the functional changes and their risk factors in children with CP their caregivers. Plus, the pathogenic genes and imaging features will be explored in this study. These will help understand the the progression of disease changes in children with CP and the impact of the targeted disease on caregivers. Also, more new and valuable evidence about etiology of CP will be unveiled. Trial registration: The study protocol (2023-12-22) has been registered with the Chinese Clinical Trial Registry (NO. ChiCTR2300079017). cerebral palsy children functional developmental trends genetic etiology imaging examination cohort protocol. Figures Figure 1 INTRODUCTION Cerebral palsy (CP) refers to a group of permanent motor dysfunction and abnormal posture that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders and abnormal posture of CP may be accompanied with disturbances of language, cognition, sensation and behavior, epilepsy, and secondary musculoskeletal deformities [1] . CP is the most common cause of children's physical disability, with an incidence rate of 2.0‰-3.5‰. It is estimated that there are about 20 million children with CP in the world [2] . The quality of life and social life abilities of CP are limited to varying degrees, which brings heavy economic and mental burden to their families and the whole society. Until now, there is an on-going need for evidence to substantiate the values of treatments for CP, and many of which have unsatisfactory therapeutic effects. Besides, the heterogeneity in etiology and clinical manifestations is enormous, which leads to the big challenges in clinical management in CP [3] . Therefore, exploring the etiology of CP and its targeted treatments has become the key issue to improve the health in this group. At present, cohort studies have analyzed the relevant risk factors and functional development trends of CP [4-8] , but there is a big gap in cohort studies of CP in China. In addition, the influencing factors of quality of life, sleep, and pain in children with CP are not clear yet, and there is a lack of longitudinal follow-ups. Importantly, the characteristics of brain injury and the pathogenesis of CP are waiting for further exploration. Therefore, researches on clarifying the functional changes and elucidating the etiology of children with CP may play a key role in providing solutions for the prevention and treatment of CP and helping with the decision-making of health management. Risk factors and genetic etiology So far, the risk factors of CP have been reported a lot, such as premature birth, low birth weight, ischemia and jaundice [9] . The risk factors can be categorized as prenatal, perinatal, and postnatal factors, with a proportion of 21%, 30.5%, 17.1%, respectively [10] . Researchers tried to find the correlation between risk factors and clinical manifestation of children with CP, as well as functional outcomes. It is known that jaundice is highly related to dyskinetic CP. In addition, gestational age seems to be limited in identifying the prognosis of CP [11] . However, there is still a significant gap in this field. Noticeably, over 30% of CP is idiopathic. It is reported that a substantial portion of individuals with CP may have an underlying genetic disorders, which is more common in idiopathic CP [12] . We previously collected 120 family blood samples of idiopathic CP, and found highly correlated genes [13] . We also performed Nogo-A gene polymorphism analysis for CP, and found that Nogo-A might affect mild types of CP and there might be sex-related differences [14] . Although it was reported that the diagnostic yield of exome or genome sequencing was 31.1%, the rate may be underestimate as many researches did not conduct family blood test [15] . In addition, the clinical manifestations and functional outcomes of CP with different genetic characteristics are still unclear. Evidently, further investigation of CP genetic etiology is needed to improve the eugenics and precision treatment for this group. Functional characteristics and changes in children with CP and their caregivers CP is mainly characterized by motor dysfunction and abnormal posture. In addition, nearly half individuals with CP have intellectual disability which adds substantially to the overall medical complexity [16] . Though a multicenter cross-sectional investigation, we found that 50.8% of Chinese children with CP suffer from undernutrition, and many of those have dysphagia [17] .Furthermore, the language ability, social life ability, quality of life, sleep and behaviors of children with CP can also be disturbed in varying degrees. Many of them can be also suffered from pain. However, the correlation of the functions or disorders still remain unclear. And there is a lack of long-term large-scale follow-up surveys on these aspects. In addition the prognosis of children with CP, the quality of life and emotions of caregivers deserve attention. Imaging examination for CP As for now, brain magnetic resonance imaging (MRI) is an important auxiliary method for the diagnosis of CP, which can help identify the location and degree of brain injury. Previous study found that preterm infants with high risk of CP have abnormal brain metabolites through MR spectroscopy [18] . But it is unclear the characteristics brain metabolites of children with CP of different ages and types. Further research on brain injury of CP may improve treatment strategies for CP. Hip dislocation and scoliosis are common secondary musculoskeletal changes, especially for children with severe motor dysfunction. It is advised that regular X-rays examination of hip joint and spine should be conducted for children with hip dislocation and scoliosis according to the clinical manifestation. And there is a need to investigate structural changes in hip joint and spine for this group of children. AIMS The aims of the present study are as follows: To observe the characteristics and changes in functions (including gross and fine motor function, language and cognitive function, eating and drinking ability, social life ability, pain, sleep quality, behavior problems and quality of life) of children with CP, as well as analyzing the risk factors; To determine the longitudinal changes in emotion and quality of life of caregivers; To analyze the characteristics of brain damage in children with CP; To explore the correlation between pathogenic genes of CP and clinical manifestations; 5. To establish a Chinese cohort information management system for CP, thus to improve the systematic clinical management of this group. METHODS AND ANALYSIS Study design and setting This study is a prospective cohort study, which explores the characteristics and interrelationships of high-risk factors, functions, imaging examinations, genetic analysis, and biochemical indicators for CP, as well as the emotion and quality of life for caregivers. In addition, the longitudinal changes in function for CP and the emotions and quality of life for caregiver are analyzed. It was designed and will be conducted by the Department of Rehabilitation, Guangzhou Women and Children's Medical Center (GWCMC), China. Participants and recruitment Physicians of GWCMC make a diagnosis of CP for children according to the International diagnostic standards for CP. All departments in this hospital related to CP are encouraged to refer children for this study. In addition, we encourage hospitals in China to refer children with CP to the department of GWCMC for study. Details of this study are explained by researchers to children who met the inclusion criteria and their caregivers. After the child and their caregivers confirm their participation in the study, the signing of the informed consent form will be completed. A cohort information management system is instructed for the information recording, follow-up, and information management of CP. Figure 1 shows the details of the recruitment and follow-up of the study. Selection criteria Inclusion criteria: diagnosed as CP according to international diagnostic standards [2] ; aged 1 to 17 years old; being able to visit the GWCMC for regular follow-ups (1-2 years old, follow-up every 2 months; 3-6 years old, follow-up every 3 months; 7-17 years old, follow-up every 6 months); parents and children (aged 8 and above) agree and sign an informed consent form. Exclusion criteria: be diagnosed with progressive or neurodegenerative diseases; the clinical condition is unstable, making it impossible to complete clinical evaluation. Sample size calculations The sample size was calculated using PASS software (version 15.0), and the selected method was linear regression. The test efficacy was 0.95, the test level was 0.05. The value of β1 is 0.25, the standard deviation of the independent variable is 5.0, the standard deviation of the dependent variable is 2.0, and the calculated result is 1289. Considering a 20% dropout rate, the final sample size is 1547. Data collection During the first visit, the researchers will inform caregivers about the details of the present study before enrollment and signing the informed consent. Then the basis information inquiry will be completed by researchers and the baseline assessment of the participants and caregivers will be conducted. Researchers will inform the participants for the subsequent functional assessments, covering the gross and fine motor function, language and cognitive function, eating and drinking ability, social life ability, pain, sleep quality, behavior problems and quality of life of children with CP, as well as the emotion and quality of life of caregivers. Medical records of participants are accessible through the hospital information system. The results of imaging examination for each participant will be obtained from the medical imaging management system of GWCMC. Each participant and their immediate families with blood ties will provide 4mL of peripheral venous blood. All the samples will be stored in the clinical biological resource library of GWCMC at -80 ℃. The samples will be used for the analysis of whole genome and 25 hydroxyvitamin D, transforming growth factor, creatine kinase, proinflammatory cytokines and other related blood indicators. All the above results and information will be recorded in cohort information management system of CP. Any medical records related to the study will not be exposed without the permission of the principal investigator. Measurements and procedures After being diagnosed as CP, children attend the department of rehabilitation of GWCMC with their caregivers for clinical assessments, imaging examination and blood tests. Table 1 shows the overview of functional assessments for children with CP at different ages. 1. Functional assessments for children with CP Clinical assessments involve gross and fine motor function, language and cognitive function, swallowing function, social life ability, pain, sleep quality, and quality of life. In addition to the baseline evaluation, participants and their caregivers will be regularly invited to return to the hospital for follow-ups. Follow up time is based on age groups considering the functional changes and follow-up compliance at different ages: participants aged 1-2, 3-6, and 7-17 years old receive follow-ups every 2 months, 3 months, and 6 months, respectively. All participants will be followed up until the age of 18 until the end of the study. Assessments will be conducted by well-experienced and qualified evaluators from the department of rehabilitation of GWCMC. (1) Gross motor function Gross motor function classification system (GMFCS) and gross motor function measurement (GMFM) will be conducted to evaluate the severity of gross motor function. The GMFCS is a five-level classification system, the severity of gross motor dysfunction in GMFCS level I to V aggravate sequentially [19] . GMFM covers five domains, including lying and rolling; sitting; crawling and kneeling; standing; and walking, running and jumping. Scores are expressed as a percentage of the maximum score [20] . (2) Fine motor function Manual ability classification system (MACS) or mini-MACS, Melbourne assessment, Box and Block test and selective control scale of upper extremity will be used for the evaluation of fine motor function. Based on the performance of upper limb movement on daily activities, MACS or mini-MACS classifies the upper limb function of children as five levels. MACS and mini-MACS are shown good reliability and among children with CP aged 1-3 years and 4-18 years, respectively [21] . The Melbourne assessment is a criterion referenced tool designed to measure the quality of unilateral upper limb movement in children with a neurological impairment, covering four main elements (range of motion, accuracy, dexterity and fluency) [22] . Box and Block test mainly assesses dexterity of the upper extremity and eye-hand coordination [23] . Selective control scale of upper extremity allows evaluation of the features of impaired selective motor control at upper extremity joint levels, which has good validity and reliability in children with CP [24] . Well-experienced occupational therapists will complete all the assessments of upper limb motor function (3) Muscle tone and contracture The modified Ashworth scale (MAS) will be conducted for the evaluation of the muscle tone in this study. The degree of spasticity is divided into 6 levels according to the scale (0, 1, 1+, 2, 3, 4), with 0 being no increase in muscle tone and 4 being affected part(s) rigid in flexion or extension [25] . The contracture is determined based on joint deformities and range of motion by physiotherapists. (4) Cognition and communication function The ability of cognition will be assessed via Wechsler Intelligence Scale for Children-fourth edition (WISC-IV) or Wechsler Preschool and Primary Scale of Intelligence-fourth Edition (WPPSI-IV). WISC-IV and WPPSI-IV are the most popular intelligence tests in applied psychological practice aiming at school children and preschool children, respectively [26,27] . Communication function classification system (CFCS) allows clinicians to classify children’s communication skills into one of five levels of function [28] . Qualified speech and language therapists will conduct the assessments for participants. (5) Eating and Drinking Ability Eating, drinking and swallowing abilities of children with CP will be evaluated using eating and drinking ability classification system (EDACS) or mini-EDACS, which are aiming at children older than 5 years and children aged 1 or 2 years old, respectively. EDACS and mini-EDACS are classified into five distinct levels based on the key features of safety and efficiency [29,30] . The above assessments will be completed by experienced occupational therapists. (6) Quality of life and social life ability Quality of life and social life ability will be assessed using the Pediatric Quality of Life Inventory (PedsQL) 3.0 CP Module and social life ability scale for Chinese infant–junior school students, respectively. The quality of life assessment include sub-areas: daily activities, movement and balance, pain and hurt, fatigue, eating activities and communication [31] . Social life ability scale is comprised six domains: independent living, athletic abilities, operational abilities, communicative abilities, participation in collective activities, and self-management abilities [32] . The assessments will be reported by caregivers under the guidance of clinicians or therapists in this study. (7) Behavior problems The severity of behavior problems will be determine using the Conners' Parent Rating Scale. It is a scale recovering 7 factors: cognitive problems, oppositional, hyperactivity-impulsivity, anxious-shy, perfectionism, social problems, and psychosomatic [33] . In the present study, Parents will rate the scores based on daily performance of their child under the instruction of researchers. (8) Nutritional status Anthropometric parameters will be measured for the evaluation of nutritional status. Weight of each participant is measured using a digital weighing scale barefoot and with minimum clothing. Standing height of participants over 2 years old who are able to stand independently or under assistance is measured using a length board. For those who were unable to stand under assistance or have severe lower limb joint contracture/deformity, height is estimated according to Stevenson’s equation (height (cm)=(tibial length×3.26) + 30.8) [34] . Recumbent length of participants under 2 years old were measured using a length board. All the above anthropometric parameters for each participant are measured for three times and the average value is calculated. WHO Anthro software (version 3.2.2) for children aged 1-5 yeas or AnthroPlus software (version 1.0.4) for children over 5 years is used for the calculation of weight-for-age z-score (WAZ), height-for-age z-score (HAZ), weight-for-height z-score (WHZ) and BMI-forage z-score (BAZ). Based on the WHO growth charts and the standards of American Society for Parenteral and Enteral Nutrition, the nutritional status was classified into mild undernutrition (–2<WHZ/BAZ≤–1), moderate undernutrition (–3<WAZ/HAZ/WHZ/BAZ≤–2), severe undernutrition (WAZ/HAZ/WHZ/BAZ≤–3), overweight (2; ≥5 years, BAZ>1), obesity (3; ≥5 years, BAZ>2) and normal [35,36] . (9 )Pain Visual analog scale will be used for participants aged 7 and above who have a basic understanding of numbers. The scale is composed of a 100mm straight line, with one end representing "completely painless" and the other end representing "pain to the extreme". Participants will be asked to mark the corresponding position on this line to represent the intensity of the pain they suffer under the instruction of a trained nurse or physiotherapist [37] . For participants under the age of 7 or those who don’t understand the meaning of numbers, a trained nurse or physiotherapist will determine the pain intensity based on the participant’s facial expression according to the Faces Pain Rating Scale, which depicts the different facials expressions when children suffer varying degrees of pain [38] . (10) Sleep quality In order to evaluate the sleep problems, sleep disturbance scale for children will be used for participants aged 6-18 years old [39] . Caregivers assesses the the occurrence of sleep disturbances over the past 6 months under the instruction of researchers. 2. Clinical assessments for caregivers (1) Emotional problems Self-rating anxiety scale and self-rating depression scale will be used to discriminate anxiety or depression from mood disorders, respectively. The items of the two scales cover a variety of anxiety or depression symptoms, with good psychometric credentials. Caregivers are given on a 4-point scale which range from 1 ( none, or a little of the time ) to 4 ( most, or all of the time ). Participants are instructed to base their answers on their experiences over the last week. Items include both negative and positive experiences, with the latter being reverse scored [40] . (2) Health-related quality of life Caregivers complete the 36-Item Short Form Health Survey questionnaire (SF-36), for evaluating health-related quality of life under the instruction of researchers. The SF-36 is a self-reported scale, which measures eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health [41] . 3. Imaging examination During the study, each participant will be examined with brain MRI, diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS) once or twice to observe the brain damage. For participants at risk of epilepsy, EEG screening is required. Those with abnormal results should undergo follow-up within 3 months, and the subsequent follow-up time should be determined based on the EEG results. The frequency of hip joint X-ray examination is based on the clinical signs and GMFCS level of participants [42] . For children with signs of scoliosis, spinal X-ray examination is required, and regular follow-ups should be conducted based on the X-ray results and the age of the child. All the above imaging examinations and analysis are conducted by radiologists and technicians from GWCMC. 4. Analysis of whole-genome and biochemical indicators Peripheral venous blood of participants and their lineal relatives (blood related parents and siblings) is collected once or twice by nurses for whole-genome analysis and detection of 25 hydroxyvitamin D, transforming growth factor, creatine kinase, proinflammatory cytokines and other related blood indicators. The blood collection operation is conducted by professional nurses, and the collection time is from 8:00 am to 12:00 am, with each person providing 4mL of blood each time. The blood is divided into 2 sterile collection tubes of 2mL and then each tube of blood sample is centrifuged into serum and blood cells. Pre processed samples are stored in the clinical biological resource library of GWCMC at -80 ℃ and waiting for analysis. Analysis of whole-genome and biochemical indicators is conducted by molecular biology and laboratory experts. Data management and monitoring 1.Data management The study intends to establish a cohort information management system for children with CP. The system is collected to the hospital information system and record, retrieve, and analyze relevant information, covering the modules of follow-up plan management, automatic reminders, and follow-up record management. A dedicated research coordinator is responsible for the management and data inspection for this system. To ensure data reliability, evaluators are not involved in data management. At the same time, the system is equipped with logic check function and information security protection measures, which can detect and correct abnormal data, and ensure the security of the data. 2.Reliability of the evaluation results The evaluators involved in this study are all well-experienced with corresponding evaluation qualifications. In addition, only if the consistency of the same evaluation project is over 95% (more than 50 samples), they must undergo a test (over 95%) of the results before they participate in this study. 3.Blood sample quality control All blood samples in this study are pre processed and stored in the biological sample library of GWCMC. Professionals are responsible for timely docking, transportation, and sample storage. The usage of samples needs to go through a strict approval process within the hospital and an informed consent is needed. Furthermore, molecular biology experts are responsible for the quality control of the analysis of whole-genome and biochemical indicators. 4.Reliability of the statistical analysis methods We will invite 2 statistical experts to inspect and confirm the statistical methods used in this study, and conduct reliability tests on the statistical analysis results. Statistical considerations For continuous variables, we will use means and SDs to present normally distributed data; for other data, we will use medians and interquartile ranges (IQRs). Numbers and percentages will be used for categorical variables. Continuous variables will be compared using the t -test or Mann-Whitney test, categorical variables using the χ2 test or Fisher’s exact test. Spearman's rank correlation coefficient or Pearson Correlation Coefficient will be used to analyse the correlation among high-risk factors, functions, imaging examinations, genetic analysis, and biochemical indicators for CP, as well as the emotion and quality of life for caregivers. Logistic regression binary or multivariate logistic regression, linear/non-linear mixed-effects regression models and structural-equation models will be used to explore causal inference among the above indicators. Additionally, we will perform longitudinal structural-equation modelling or growth curve analysis to evaluate the temporal effects of function for CP and the emotions and quality of life for caregiver. All of the analyses performed in this study will be considered statistically significant at a level of 5%, and 95% CIs will be calculated for all of the data. DISCUSSION This study will observe the functional changes and their risk factors in children with CP and their caregivers. Plus, the pathogenic genes and imaging features will be explored in this study. These will help understand the progression of disease changes in children with CP and the impact of the targeted disease on caregivers. Also, more new and valuable evidence about etiology of CP will be unveiled. The results of this study will be published in highly regarded international journals, and will be presented at national and international conferences. Furthermore, our study findings be translated into clinical practice, inform policy decisions and guide the appropriate allocation of limited healthcare resources. Abbreviations CP: Cerebral palsy MRI: Magnetic resonance imaging GWCMC: Guangzhou Women and Children's Medical Center GMFCS: Gross motor function classification system GMFM: Gross motor function measurement MACS: Manual ability classification system MAS: Modified Ashworth scale WISC-IV: Wechsler Intelligence Scale for Children-fourth edition WPPSI-IV: Wechsler Preschool and Primary Scale of Intelligence-fourth Edition CFCS: Communication function classification system EDACS: Eating and drinking ability classification system PedsQL: Pediatric Quality of Life Inventory WAZ: Weight-for-age z-score HAZ: Height-for-age z-score WHZ: Weight-for-height z-score BAZ: BMI-forage z-score SF-36: 36-Item Short Form Health Survey questionnaire DTI: Diffusion tensor imaging MRS: Magnetic resonance spectroscopy IQRs: interquartile ranges Declarations ETHICS Approval was obtained by the Research Ethics Committee of GWCMC, which has accepted responsibility for supervising all aspects of the study (NO. 2023346A01). All parents or guardians or caregivers of children under 8 years old who agree to participate in the study will sign informed consent. The study protocol (2023-12-22) has been registered with the Chinese Clinical Trial Registry (NO. ChiCTR2300079017). Only the researchers associated with the study and the Ethics Committee would have access to the research data. Acknowledgements The authors would like to thank all the research participants along with their families for their valuable time and contributions to this research project. Contributors KSX and WHZ contributed to the study conception and planning of the work. TTP (senior, 1996) and TTP (junior, 2001) were responsible for writing the manuscript. JLL, LH, HMT, JL, JZ, TG, FW and HSL all contributed to the editing of the manuscript. ZYH, DXF and LP contributed to the design of the table and graph. QFH, YZ, MRZ, YGZ and RJL were involved in literature search. JHL, LRL, YZ, JBZ and HYZ were responsible for the design of evaluation and analysis process. All authors provided critical feedback and helped shape the research and analysis plan and the final manuscript. Funding This work was supported by the Featured Clinical Technique of Guangzhou (2023C-TS59), Guangzhou Municipal Science and Technology Project (2024A03J01274) and Guangzhou Medical University Research Capability Enhancement Program - Major Clinical Research Project. Competing interests None declared. Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement Further details of the study protocol can be requested from the corresponding author. References Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet. 2014,383(9924):1240-1249. 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Orthop Clin North Am. 2018,49(2):181-190. Tables Table 1 Functional assessments for children with cerebral palsy at different ages Outcome Measurements Age （ year ） 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Gross motor function GMFCS √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ GMFM √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Upper limb motor function MACS √ √ √ √ √ √ √ √ √ √ √ √ √ √ Mini-MACS √ √ √ MA2 √ √ √ √ √ √ √ √ √ √ √ Box and Block test √ √ √ √ √ √ √ √ √ √ √ √ √ SCUES √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Cognition and communication WISC-IV √ √ √ √ √ √ √ √ √ √ WPPSI-IV √ √ √ √ CFCS √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Eating and Drinking Ability EDACS √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Mini-EDACS √ √ Quality of life and social life ability PedsQL 3.0 CP Module √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ social life ability scale for Chinese infant–junior school students √ √ √ √ √ √ √ √ √ √ √ √ √ Behavior Conners' parent rating scale √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Nutritional status Height and weight √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Pain and sleep Visual analog scale √ √ √ √ √ √ √ √ √ √ √ Faces pain rating scale √ √ √ √ √ √ Sleep disturbance scale for children √ √ √ √ √ √ √ √ √ √ √ Muscle tone and contracture Modified Ashworth scale √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Range of motion √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ GMFCS: Gross motor function classification system; GMFM: Gross motor function measurement; MACS: Manual Ability Classification System; MA2: The Melbourne Assessment of Unilateral Upper Limb Function; SCUES: Selective Control of the Upper Extremity Scale; WISC-IV: Wechsler Intelligence Scale for Children-fourth edition; WPPSI-IV: Wechsler Preschool and Primary Scale of Intelligence-fourth Edition; CFCS: Communication Function Classification System; EDACS: Eating and Drinking Ability Classification System; PedsQL: Pediatric Quality of Life Inventory. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3996459","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Study protocol","associatedPublications":[],"authors":[{"id":276188460,"identity":"fe696d6e-6535-406f-9d68-9edb0c45ffa0","order_by":0,"name":"Tingting Peng","email":"","orcid":"","institution":"Department of Rehabilitation, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Tingting","middleName":"","lastName":"Peng","suffix":""},{"id":276188461,"identity":"02347713-193b-42d8-9677-f5d73cbf87b6","order_by":1,"name":"Tingting 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11:07:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3996459/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3996459/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":52033033,"identity":"e9d86096-9553-4173-8cc7-d9324bba35ba","added_by":"auto","created_at":"2024-03-05 16:39:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":281367,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flowchart\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3996459/v1/63abc2835e8364e52635bcef.png"},{"id":52514737,"identity":"3c1fe37b-3646-42f6-a0ac-167f68a948f7","added_by":"auto","created_at":"2024-03-12 12:25:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":858693,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3996459/v1/d19aa79b-1c8b-456d-9364-04f3f8e68126.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Longitudinal cohort protocol study of children with cerebral palsy in China: functional developmental trends, genetic etiology and imaging features of brain","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCerebral palsy (CP) refers to a group of\u0026nbsp;permanent\u0026nbsp;motor dysfunction and abnormal posture that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders and abnormal posture of CP may be accompanied with\u0026nbsp;disturbances\u0026nbsp;of\u0026nbsp;language, cognition,\u0026nbsp;sensation\u0026nbsp;and\u0026nbsp;behavior, epilepsy, and secondary musculoskeletal deformities\u003csup\u003e[1]\u003c/sup\u003e. CP is the most common cause of children\u0026apos;s physical disability, with an incidence rate of 2.0\u0026permil;-3.5\u0026permil;. It is estimated that there are about 20 million children with CP in the world\u003csup\u003e[2]\u003c/sup\u003e. The quality of life and social life abilities of CP are limited to varying degrees, which brings heavy economic and mental burden to their families and the whole society.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUntil now, there is an on-going need for evidence to substantiate the values of treatments for CP, and many of which have unsatisfactory therapeutic effects. Besides, the heterogeneity in etiology and clinical manifestations is enormous, which leads to the big challenges in clinical management in CP\u003csup\u003e[3]\u003c/sup\u003e. Therefore, exploring the etiology of CP and its targeted treatments has become the key issue to improve the health in this group. At present, cohort studies have analyzed the relevant risk factors and functional development trends of CP\u003csup\u003e[4-8]\u003c/sup\u003e, but there is a big gap in cohort studies of CP in China. In addition, the influencing factors of quality of life, sleep, and pain in children with CP are not clear yet, and there is a lack of longitudinal follow-ups. Importantly, the characteristics of brain injury and the pathogenesis of CP are waiting for further exploration. Therefore, researches on clarifying the functional changes and elucidating the etiology of children with CP may play a key role in providing solutions for the prevention and treatment of CP and helping with the decision-making of health management.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRisk factors and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003egenetic etiology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSo far, the risk factors of CP have been reported a lot, such as premature birth, low birth weight, ischemia and jaundice\u003csup\u003e[9]\u003c/sup\u003e. The risk factors\u0026nbsp;can be categorized as\u0026nbsp;prenatal, perinatal,\u0026nbsp;and\u0026nbsp;postnatal\u0026nbsp;factors, with a proportion of\u0026nbsp;21%, 30.5%, 17.1%,\u0026nbsp;respectively\u003csup\u003e\u0026nbsp;[10]\u003c/sup\u003e. Researchers tried to find the correlation between risk factors and clinical manifestation of children with CP, as well as functional outcomes. It is known that\u0026nbsp;jaundice is highly related to dyskinetic CP. In addition,\u0026nbsp;gestational age\u0026nbsp;seems to be\u0026nbsp;limited\u0026nbsp;in identifying the prognosis of CP\u003csup\u003e[11]\u003c/sup\u003e. However, there is still a significant gap in this field.\u003c/p\u003e\n\u003cp\u003eNoticeably, over 30%\u0026nbsp;of CP is\u0026nbsp;idiopathic. It is reported that\u0026nbsp;a substantial portion of individuals with CP may have an underlying genetic disorders, which is more common in\u0026nbsp;idiopathic CP\u003csup\u003e[12]\u003c/sup\u003e.\u0026nbsp;We previously collected 120 family blood samples of idiopathic CP, and found highly correlated genes\u003csup\u003e[13]\u003c/sup\u003e. We also performed Nogo-A gene polymorphism analysis for CP, and found that\u0026nbsp;Nogo-A might affect mild types of CP and there might be sex-related differences\u003csup\u003e[14]\u003c/sup\u003e. Although it was reported that the\u0026nbsp;diagnostic yield of exome or genome sequencing was 31.1%, the rate may be underestimate as many researches did not conduct family blood test\u003csup\u003e[15]\u003c/sup\u003e. In addition, the clinical manifestations and functional outcomes of CP with different genetic characteristics are still unclear. Evidently, further investigation of CP\u0026nbsp;genetic etiology is needed to improve the eugenics and precision treatment for this group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunctional characteristics and changes in children with CP and their caregivers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCP is mainly characterized by motor dysfunction and abnormal posture. In addition, nearly half individuals with CP have intellectual disability which\u0026nbsp;adds substantially to the overall medical complexity\u003csup\u003e[16]\u003c/sup\u003e.\u0026nbsp;Though a\u0026nbsp;multicenter cross-sectional investigation, we found that\u0026nbsp;50.8% of Chinese children with CP suffer from undernutrition, and many of those have dysphagia\u003csup\u003e[17]\u003c/sup\u003e.Furthermore, the\u0026nbsp;language ability,\u0026nbsp;social\u0026nbsp;life\u0026nbsp;ability, quality of life,\u0026nbsp;sleep and behaviors of children with CP can also be disturbed\u0026nbsp;in varying degrees. Many of them can be also suffered from pain. However, the correlation of the functions or disorders still remain unclear. And there is a lack of long-term large-scale follow-up surveys on these aspects. In addition the prognosis of children with CP, the quality of life and emotions of caregivers deserve attention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImaging examination for CP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs for now, brain magnetic resonance imaging (MRI) is an important auxiliary method for the diagnosis of CP, which can help identify the location and degree of brain injury. Previous study found that preterm infants with high risk of CP have\u0026nbsp;abnormal brain metabolites\u0026nbsp;through\u0026nbsp;MR spectroscopy\u003csup\u003e[18]\u003c/sup\u003e. But it is unclear the\u0026nbsp;characteristics\u0026nbsp;brain metabolites\u0026nbsp;of children with CP of different ages and types. Further research on brain injury of CP may improve treatment strategies for CP.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHip dislocation and scoliosis are common secondary musculoskeletal changes, especially for children with severe motor dysfunction. It is advised that regular X-rays examination of hip joint and spine should be conducted for children with hip dislocation and scoliosis according to the clinical manifestation. And there is a need to investigate structural changes in hip joint and spine for this group of children.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAIMS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;aims of the present study are as follows:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eTo observe the characteristics and changes in functions (including gross and fine motor function, language and cognitive function, eating and drinking ability, social life ability, pain, sleep quality, behavior problems and quality of life) of children with CP, as well as analyzing the risk factors;\u003c/li\u003e\n \u003cli\u003eTo determine the longitudinal changes in emotion and quality of life of caregivers;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eTo analyze the characteristics of brain damage in children with CP;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eTo explore the correlation between pathogenic genes of CP and clinical manifestations;\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e5. To establish a Chinese cohort information management system for CP, thus to improve the systematic clinical management of this group.\u003c/p\u003e"},{"header":"METHODS AND ANALYSIS ","content":"\u003cp\u003e\u003cstrong\u003eStudy design and setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is a prospective cohort study, which\u0026nbsp;explores the characteristics and interrelationships of high-risk factors, functions, imaging examinations, genetic analysis, and biochemical indicators for CP, as well as the emotion and\u0026nbsp;quality of\u0026nbsp;life\u0026nbsp;for caregivers. In addition, the longitudinal changes in function for CP and the emotions and quality of life for caregiver are analyzed.\u0026nbsp;It was designed and will be conducted by the Department of\u0026nbsp;Rehabilitation,\u0026nbsp;Guangzhou Women and Children\u0026apos;s Medical Center\u0026nbsp;(GWCMC), China.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants and recruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePhysicians of\u0026nbsp;GWCMC\u0026nbsp;make a diagnosis of CP for children according to the International diagnostic standards for CP.\u0026nbsp;All\u0026nbsp;departments in this hospital related to CP are encouraged to refer children\u0026nbsp;for this study. In addition, we encourage hospitals in China to refer children with CP to the department of\u0026nbsp;GWCMC for study.\u0026nbsp;Details of this study are explained by researchers to children who met the inclusion criteria and their caregivers. After the child and their caregivers confirm their participation in the study, the signing of the informed consent form\u0026nbsp;will be completed.\u0026nbsp;A cohort information management system is instructed for the information recording, follow-up, and information management of CP. Figure 1 shows the details of the\u0026nbsp;recruitment and\u0026nbsp;follow-up of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSelection criteria\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion criteria:\u0026nbsp;diagnosed as CP according to international diagnostic standards\u003csup\u003e[2]\u003c/sup\u003e; aged 1 to 17 years old; being able to visit the\u0026nbsp;GWCMC\u0026nbsp;for regular follow-ups (1-2 years old, follow-up every 2 months; 3-6 years old, follow-up every 3 months; 7-17 years old, follow-up every 6 months); parents and children (aged 8 and above) agree and sign an informed consent form.\u003c/p\u003e\n\u003cp\u003eExclusion criteria:\u0026nbsp;be diagnosed with progressive or neurodegenerative diseases; the clinical condition is unstable, making it impossible to complete clinical evaluation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size calculations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size was calculated using PASS software (version 15.0), and the selected method was linear regression. The test efficacy was 0.95, the test level was 0.05. The value of \u0026beta;1 is 0.25, the standard deviation of the independent variable is 5.0, the standard deviation of the dependent variable is 2.0, and the calculated result is 1289. Considering a 20% dropout rate, the final sample size is 1547.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the first visit, the researchers will inform caregivers about the details of the present study before enrollment and signing the informed consent. Then the basis information inquiry will be completed by researchers and the baseline assessment of the participants and caregivers will be conducted. Researchers will inform the participants for the subsequent functional assessments, covering the gross and fine motor function, language and cognitive function, eating and drinking ability, social life ability, pain, sleep quality, behavior problems and quality of life of children with CP, as well as the emotion and quality of life of caregivers.\u0026nbsp;Medical records of participants are accessible through the hospital information system. The results of imaging examination for each participant will be obtained from the medical imaging management system of GWCMC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEach participant and their immediate families with blood ties will provide\u0026nbsp;4mL of peripheral venous blood.\u0026nbsp;All the samples will be stored in the clinical biological resource library of\u0026nbsp;GWCMC\u0026nbsp;at -80 ℃. The samples will be used for the analysis of\u0026nbsp;whole genome and\u0026nbsp;25 hydroxyvitamin D, transforming growth factor, creatine kinase, proinflammatory cytokines and other related blood indicators.\u003c/p\u003e\n\u003cp\u003eAll the above results and information will be recorded in\u0026nbsp;cohort information management system of CP.\u0026nbsp;Any medical records related to the study will not be exposed without the permission of the principal investigator.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasurements and procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter being diagnosed as CP, children attend the department of rehabilitation of GWCMC with their caregivers for clinical assessments, imaging examination and blood tests.\u0026nbsp;Table 1 shows the overview of functional assessments for children with CP at different ages.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e1.\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eFunctional assessments for children with CP\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical assessments involve gross and fine motor function, language and cognitive function, swallowing function, social life ability, pain, sleep quality, and quality of life. In addition to the baseline evaluation, participants and their caregivers will be regularly invited to return to the hospital for follow-ups. Follow up time is based on age groups considering the functional changes and follow-up compliance at different ages: participants aged 1-2, 3-6, and 7-17 years old receive follow-ups every 2 months, 3 months, and 6 months, respectively. All participants will be followed up until the age of 18 until the end of the study. Assessments will be conducted by well-experienced and qualified evaluators from the department of rehabilitation of GWCMC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(1) Gross motor function\u003c/p\u003e\n\u003cp\u003eGross motor function classification system (GMFCS) and gross motor function measurement (GMFM) will be conducted to evaluate the severity of gross motor function.\u0026nbsp;The GMFCS is a\u0026nbsp;five-level classification system, the severity of gross motor dysfunction in GMFCS level I to V aggravate sequentially\u003csup\u003e[19]\u003c/sup\u003e. GMFM covers five domains, including lying and rolling; sitting; crawling and kneeling; standing; and walking, running and jumping. Scores are expressed as a percentage of the maximum score \u003csup\u003e[20]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(2) Fine motor function\u003c/p\u003e\n\u003cp\u003eManual ability classification system (MACS) or mini-MACS,\u0026nbsp;Melbourne assessment, Box and Block test and selective control scale of upper extremity will be used for the evaluation of fine motor function. Based on the performance of upper limb movement on daily activities,\u0026nbsp;MACS or mini-MACS classifies the upper limb function of children as\u0026nbsp;five levels. MACS and mini-MACS are shown good reliability and among children with CP aged 1-3 years and 4-18 years, respectively\u003csup\u003e[21]\u003c/sup\u003e.\u0026nbsp;The Melbourne\u0026nbsp;assessment is a criterion referenced tool designed to measure the quality of\u0026nbsp;unilateral\u0026nbsp;upper limb movement in children with a neurological impairment, covering four main elements\u0026nbsp;(range of motion,\u0026nbsp;accuracy,\u0026nbsp;dexterity\u0026nbsp;and\u0026nbsp;fluency)\u003csup\u003e[22]\u003c/sup\u003e.\u0026nbsp;Box and Block test mainly\u0026nbsp;assesses\u0026nbsp;dexterity\u0026nbsp;of the upper extremity and\u0026nbsp;eye-hand coordination\u003csup\u003e\u0026nbsp;[23]\u003c/sup\u003e. Selective control scale of upper extremity\u0026nbsp;allows evaluation of the features of impaired selective motor control at upper extremity joint levels, which has good\u0026nbsp;validity and reliability in\u0026nbsp;children\u0026nbsp;with\u0026nbsp;CP\u003csup\u003e\u0026nbsp;[24]\u003c/sup\u003e.\u0026nbsp;Well-experienced occupational therapists will complete all the assessments of upper limb motor function\u003c/p\u003e\n\u003cp\u003e(3) Muscle tone and contracture\u003c/p\u003e\n\u003cp\u003eThe modified Ashworth scale (MAS) will be conducted for the evaluation of the muscle tone in this study. The degree of spasticity is divided into 6 levels according to the scale (0, 1, 1+, 2, 3, 4), with 0 being no increase in muscle tone and 4 being affected part(s) rigid in flexion or extension \u003csup\u003e[25]\u003c/sup\u003e. The\u0026nbsp;contracture is determined based on joint deformities and range of motion by physiotherapists.\u003c/p\u003e\n\u003cp\u003e(4) Cognition and communication function\u003c/p\u003e\n\u003cp\u003eThe ability of cognition will be assessed via Wechsler Intelligence Scale for Children-fourth edition (WISC-IV) or\u0026nbsp;Wechsler Preschool and Primary Scale of Intelligence-fourth Edition\u0026nbsp;(WPPSI-IV).\u0026nbsp;WISC-IV and\u0026nbsp;WPPSI-IV are\u0026nbsp;the most popular intelligence tests in applied psychological practice\u0026nbsp;aiming at school children and preschool children, respectively\u003csup\u003e[26,27]\u003c/sup\u003e.\u0026nbsp;Communication\u0026nbsp;function\u0026nbsp;classification\u0026nbsp;system (CFCS) allows clinicians to classify children\u0026rsquo;s communication skills into one of five levels of function\u003csup\u003e[28]\u003c/sup\u003e. Qualified speech and language therapists\u0026nbsp;will conduct the assessments for participants.\u003c/p\u003e\n\u003cp\u003e(5) Eating and Drinking Ability\u003c/p\u003e\n\u003cp\u003eEating, drinking and swallowing abilities of children with CP will be evaluated using eating and drinking ability classification system (EDACS) or mini-EDACS, which are aiming at children older than 5 years and children aged 1 or 2 years old, respectively. EDACS and mini-EDACS are classified into five distinct levels based on the key features of safety and efficiency \u003csup\u003e[29,30]\u003c/sup\u003e. The above assessments will be completed by experienced occupational therapists.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(6) Quality of life and social life ability\u003c/p\u003e\n\u003cp\u003eQuality of life and social life ability will be assessed using\u0026nbsp;the Pediatric Quality of Life Inventory (PedsQL) 3.0 CP\u0026nbsp;Module\u0026nbsp;and\u0026nbsp;social life ability scale for Chinese infant\u0026ndash;junior school students, respectively.\u0026nbsp;The quality of life assessment include sub-areas:\u0026nbsp;daily activities, movement and balance, pain and hurt, fatigue, eating activities\u0026nbsp;and communication\u003csup\u003e[31]\u003c/sup\u003e.\u0026nbsp;Social life ability scale is comprised six domains: independent living, athletic abilities, operational abilities, communicative abilities, participation in collective activities, and self-management abilities\u003csup\u003e[32]\u003c/sup\u003e. The assessments will be reported by caregivers under the guidance of clinicians or therapists in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(7) Behavior problems\u003c/p\u003e\n\u003cp\u003eThe severity of behavior problems will be determine using the Conners\u0026apos; Parent Rating Scale.\u0026nbsp;It is a scale recovering 7\u0026nbsp;factors:\u0026nbsp;cognitive\u0026nbsp;problems,\u0026nbsp;oppositional,\u0026nbsp;hyperactivity-impulsivity,\u0026nbsp;anxious-shy,\u0026nbsp;perfectionism,\u0026nbsp;social\u0026nbsp;problems, and\u0026nbsp;psychosomatic\u003csup\u003e[33]\u003c/sup\u003e.\u0026nbsp;In the present study, Parents will rate the scores based on daily performance of their child under the instruction of researchers.\u003c/p\u003e\n\u003cp\u003e(8) Nutritional status\u003c/p\u003e\n\u003cp\u003eAnthropometric\u0026nbsp;parameters\u0026nbsp;will be measured for the evaluation of nutritional status.\u0026nbsp;Weight of each participant is measured using a digital weighing scale barefoot and with minimum clothing. Standing height of participants over 2 years old who are able to stand\u0026nbsp;independently or under assistance\u0026nbsp;is measured\u0026nbsp;using a length board. For those who were unable to stand under assistance or have severe lower limb joint contracture/deformity, height is estimated according to Stevenson\u0026rsquo;s equation (height (cm)=(tibial length\u0026times;3.26) + 30.8)\u003csup\u003e[34]\u003c/sup\u003e. Recumbent length of participants under 2 years old were measured using a length board. All the above anthropometric parameters for each participant are measured for three times and the average value is calculated. WHO Anthro software (version 3.2.2) for children aged 1-5 yeas or AnthroPlus software (version 1.0.4) for children over 5 years is used for the calculation of weight-for-age z-score (WAZ), height-for-age z-score (HAZ), weight-for-height z-score (WHZ) and BMI-forage z-score (BAZ). Based on the WHO growth charts and the standards of American Society for Parenteral and Enteral Nutrition, the nutritional status was classified into mild undernutrition (\u0026ndash;2\u0026lt;WHZ/BAZ\u0026le;\u0026ndash;1), moderate undernutrition (\u0026ndash;3\u0026lt;WAZ/HAZ/WHZ/BAZ\u0026le;\u0026ndash;2), severe undernutrition (WAZ/HAZ/WHZ/BAZ\u0026le;\u0026ndash;3), overweight (\u0026lt; 5 years, BAZ\u0026gt;2; \u0026ge;5 years, BAZ\u0026gt;1), obesity (\u0026lt;5 years, BAZ\u0026gt;3; \u0026ge;5 years, BAZ\u0026gt;2) and normal\u003csup\u003e[35,36]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(9 )Pain\u003c/p\u003e\n\u003cp\u003eVisual analog scale will be used for participants aged 7 and above\u0026nbsp;who have a basic understanding of numbers. The scale is composed of a 100mm straight line, with one end representing \u0026quot;completely painless\u0026quot; and the other end representing \u0026quot;pain to the extreme\u0026quot;. Participants will be asked to mark the corresponding position on this line to represent the intensity of the pain they suffer under the instruction of a trained nurse or physiotherapist\u003csup\u003e[37]\u003c/sup\u003e.\u0026nbsp;For participants under the age of 7 or those who don\u0026rsquo;t understand the meaning of numbers, a trained nurse or physiotherapist will determine the pain intensity based on the participant\u0026rsquo;s facial expression according to the Faces Pain Rating Scale, which depicts the different facials expressions when children suffer varying degrees of pain\u003csup\u003e[38]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(10) Sleep quality\u003c/p\u003e\n\u003cp\u003eIn order to evaluate the sleep problems, sleep disturbance scale for children will be used for participants aged 6-18 years old \u003csup\u003e[39]\u003c/sup\u003e. Caregivers assesses the the occurrence of sleep disturbances over the past 6\u0026thinsp;months under the instruction of researchers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e2.\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eClinical assessments for caregivers\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e(1) Emotional problems\u003c/p\u003e\n\u003cp\u003eSelf-rating anxiety scale\u0026nbsp;and self-rating depression scale will be used to\u0026nbsp;discriminate anxiety\u0026nbsp;or depression\u0026nbsp;from mood disorders, respectively. The items of the two scales cover\u0026nbsp;a variety of anxiety\u0026nbsp;or depression\u0026nbsp;symptoms, with\u0026nbsp;good psychometric credentials. Caregivers\u0026nbsp;are given on a 4-point scale which range from 1 (\u003cem\u003enone, or a little of the time\u003c/em\u003e) to 4 (\u003cem\u003emost, or all of the time\u003c/em\u003e). Participants are instructed to base their answers on their experiences over the last week. Items include both negative and positive experiences, with the latter being reverse scored \u003csup\u003e[40]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e(2) Health-related quality of life\u003c/p\u003e\n\u003cp\u003eCaregivers complete the 36-Item Short Form Health Survey questionnaire (SF-36),\u0026nbsp;for evaluating\u0026nbsp;health-related\u0026nbsp;quality of\u0026nbsp;life\u0026nbsp;under the instruction of researchers.\u0026nbsp;The SF-36\u0026nbsp;is a self-reported scale, which\u0026nbsp;measures eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health\u003csup\u003e\u0026nbsp;[41]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eImaging examination\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the study, each participant will be examined with brain MRI, diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS) once or twice to observe the brain damage. For participants at risk of epilepsy, EEG screening is required. Those with abnormal results should undergo follow-up within 3 months, and the subsequent follow-up time should be determined based on the EEG results. The frequency of hip joint X-ray examination is based on the clinical signs and GMFCS level of participants\u003csup\u003e[42]\u003c/sup\u003e. For children with signs of scoliosis, spinal X-ray examination is required, and regular follow-ups should be conducted based on the X-ray results and the age of the child. All the above imaging examinations and analysis are conducted by radiologists and technicians from\u0026nbsp;GWCMC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e4.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eAnalysis of whole-genome and biochemical indicators\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePeripheral venous blood of participants and their lineal relatives (blood related parents and siblings) is collected once or twice by nurses for whole-genome analysis and detection of 25 hydroxyvitamin D, transforming growth factor, creatine kinase, proinflammatory cytokines and other related blood indicators. The blood collection operation is conducted by professional nurses, and the collection time is from 8:00 am to 12:00 am, with each person providing 4mL of blood each time. The blood is divided into 2 sterile collection tubes of 2mL and then each tube of blood sample is centrifuged into serum and blood cells. Pre processed samples are stored in the clinical biological resource library of\u0026nbsp;GWCMC\u0026nbsp;at -80 ℃ and waiting for analysis.\u0026nbsp;Analysis of whole-genome and biochemical indicators\u0026nbsp;is conducted by molecular biology and laboratory experts.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData management and monitoring\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e1.Data management\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study intends to establish a\u0026nbsp;cohort information management system for children with CP.\u0026nbsp;The system\u0026nbsp;is\u0026nbsp;collected to\u0026nbsp;the hospital information system and\u0026nbsp;record, retrieve, and analyze relevant information,\u0026nbsp;covering the\u0026nbsp;modules of follow-up plan management, automatic reminders, and follow-up record management. A\u0026nbsp;dedicated research coordinator\u0026nbsp;is responsible for the management and data inspection for this system.\u0026nbsp;To ensure data reliability, evaluators are not involved in data management. At the same time, the system is equipped with logic check function and information security protection measures, which can detect and correct abnormal data, and ensure the security of the data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e2.Reliability of the evaluation results\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe evaluators involved in this study are all well-experienced with corresponding evaluation qualifications. In addition,\u0026nbsp;only if the consistency of the same evaluation project is over 95% (more than 50 samples), they\u0026nbsp;must undergo a test (over 95%) of the results before they participate in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.Blood sample quality control\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll blood samples in this study are pre processed and stored in the biological sample library of GWCMC. Professionals are responsible for timely docking, transportation, and sample storage. The usage of samples needs to go through a strict approval process within the hospital and an informed consent is needed. Furthermore, molecular biology experts are responsible for the quality control of the\u0026nbsp;analysis of whole-genome and biochemical indicators.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e4.Reliability of the statistical analysis methods\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe will invite 2 statistical experts to inspect and confirm the statistical methods used in this study, and conduct reliability tests on the statistical analysis results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor continuous variables, we will use means and SDs to present normally distributed data; for other data, we will use medians and interquartile ranges (IQRs). Numbers and percentages will be used for categorical variables. Continuous variables will be compared using the \u003cem\u003et\u003c/em\u003e-test or Mann-Whitney test, categorical variables using the \u0026chi;2 test or Fisher\u0026rsquo;s exact test. Spearman\u0026apos;s rank correlation coefficient or Pearson Correlation Coefficient will be used to analyse the correlation among high-risk factors, functions, imaging examinations, genetic analysis, and biochemical indicators for CP, as well as the emotion and quality of life for caregivers. Logistic regression binary or multivariate logistic regression, linear/non-linear mixed-effects regression models and structural-equation models will be used to explore causal inference among the above indicators. Additionally, we will perform longitudinal structural-equation modelling or growth curve analysis to evaluate the temporal effects of function for CP and the emotions and quality of life for caregiver. All of the analyses performed in this study will be considered statistically significant at a level of 5%, and 95% CIs will be calculated for all of the data.\u0026nbsp;\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study will observe the functional changes and their risk factors in children with CP\u0026nbsp;and\u0026nbsp;their caregivers. Plus, the pathogenic genes and imaging features will be explored in this study. These will help understand the progression of disease changes in children with CP and the impact of the targeted disease on caregivers. Also, more new and valuable evidence about etiology of CP will be unveiled.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe results of this study will be published in highly regarded international journals, and will be presented at national and international conferences. Furthermore, our study findings be translated into clinical practice, inform policy decisions and guide the appropriate allocation of limited healthcare resources.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCP: Cerebral palsy\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMRI: Magnetic resonance imaging \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGWCMC: Guangzhou Women and Children\u0026apos;s Medical Center\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGMFCS: Gross motor function classification system\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGMFM: Gross motor function measurement\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMACS: Manual ability classification system \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMAS: Modified Ashworth scale\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWISC-IV: Wechsler Intelligence Scale for Children-fourth edition \u0026nbsp;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWPPSI-IV: Wechsler Preschool and Primary Scale of Intelligence-fourth Edition \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCFCS: Communication function classification system \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEDACS: Eating and drinking ability classification system \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePedsQL: Pediatric Quality of Life Inventory \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWAZ: Weight-for-age z-score\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHAZ: Height-for-age z-score \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWHZ: Weight-for-height z-score \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBAZ: BMI-forage z-score \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSF-36: 36-Item Short Form Health Survey questionnaire \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDTI: Diffusion tensor imaging\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMRS: Magnetic resonance spectroscopy\u003c/p\u003e\n\u003cp\u003eIQRs: interquartile ranges\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eETHICS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval was obtained by the\u0026nbsp;Research Ethics Committee of\u0026nbsp;GWCMC, which has accepted responsibility for supervising all aspects of the study\u0026nbsp;(NO. 2023346A01). All parents or guardians or caregivers of children under 8 years old who agree to participate in the study will sign informed consent. The study protocol (2023-12-22) has been registered with the Chinese Clinical Trial Registry\u0026nbsp;(NO. ChiCTR2300079017). Only the researchers associated with the study and the Ethics Committee would have access to the research data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003eThe authors would like to thank all the research participants along with their families for their valuable time and contributions to this research project.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributors\u0026nbsp;\u003c/strong\u003eKSX\u0026nbsp;and WHZ\u0026nbsp;contributed to the study conception and planning of the work. TTP (senior, 1996)\u0026nbsp;and\u0026nbsp;TTP (junior, 2001)\u0026nbsp;were\u0026nbsp;responsible for writing the manuscript.\u0026nbsp;JLL,\u0026nbsp;LH,\u0026nbsp;HMT,\u0026nbsp;JL, JZ, TG, FW and HSL all\u0026nbsp;contributed to the editing of the manuscript.\u0026nbsp;ZYH,\u0026nbsp;DXF\u0026nbsp;and LP\u0026nbsp;contributed to the design of the table and graph. QFH,\u0026nbsp;YZ, MRZ, YGZ and RJL\u0026nbsp;were involved in\u0026nbsp;literature search. JHL, LRL,\u0026nbsp;YZ, JBZ\u0026nbsp;and HYZ were responsible for the design of evaluation\u0026nbsp;and analysis\u0026nbsp;process. All authors provided critical feedback and helped shape the research and analysis plan and the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003eThis work was supported by the Featured Clinical Technique of Guangzhou (2023C-TS59), Guangzhou Municipal Science and Technology Project (2024A03J01274) and Guangzhou Medical University Research Capability Enhancement Program - Major Clinical Research Project.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003eNone declared.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient and public involvement\u0026nbsp;\u003c/strong\u003ePatients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient consent for publication\u0026nbsp;\u003c/strong\u003eNot required.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProvenance and peer review\u0026nbsp;\u003c/strong\u003eNot commissioned; externally peer reviewed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData sharing statement\u003c/strong\u003e Further details of the study protocol can be requested from the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eColver A, Fairhurst C, Pharoah PO. 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Dev Med Child Neurol. 2011,53(11):1007-1012.\u003c/li\u003e\n\u003cli\u003eAlotaibi M, Long T, Kennedy E, Bavishi S. The efficacy of GMFM-88 and GMFM-66 to detect changes in gross motor function in children with cerebral palsy (CP): a literature review. Disabil Rehabil. 2014,36(8):617-627.\u003c/li\u003e\n\u003cli\u003eEliasson AC, Krumlinde-Sundholm L, R\u0026ouml;sblad B, Beckung E, Arner M, Ohrvall AM, Rosenbaum P. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006,48(7):549-554.\u003c/li\u003e\n\u003cli\u003eRandall M, Carlin JB, Chondros P, Reddihough D. Reliability of the Melbourne assessment of unilateral upper limb function. Dev Med Child Neurol. 2001,43(11):761-767.\u003c/li\u003e\n\u003cli\u003eProchaska E, Ammenwerth E. A Digital Box and Block Test for Hand Dexterity Measurement: Instrument Validation Study. 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Acta Paediatr Suppl. 2006,450:76\u0026ndash;85.\u003c/li\u003e\n\u003cli\u003eBecker PJ, Nieman Carney L, Corkins MR, Monczka J, Smith E, Smith SE, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). J Acad Nutr Diet. 2014,114:1988\u0026ndash;2000.\u003c/li\u003e\n\u003cli\u003eSung YT, Wu JS. The Visual Analogue Scale for Rating, Ranking and Paired-Comparison (VAS-RRP): A new technique for psychological measurement. Behav Res Methods. 2018,0(4):1694-1715.\u003c/li\u003e\n\u003cli\u003eicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001,93(2):173-183.\u003c/li\u003e\n\u003cli\u003eBruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, Giannotti F. The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996,5(4):251-2\u003c/li\u003e\n\u003cli\u003eDunstan DA, Scott N, Todd AK. Screening for anxiety and depression: reassessing the utility of the Zung scales. BMC Psychiatry. 2017,17(1):329.\u003c/li\u003e\n\u003cli\u003eLins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016,4:2050312116671725.\u003c/li\u003e\n\u003cli\u003eHuser A, Mo M, Hosseinzadeh P. Hip Surveillance in Children with Cerebral Palsy. Orthop Clin North Am. 2018,49(2):181-190.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1 Functional assessments for children with cerebral palsy at different ages\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"603\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.642384105960264%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome Measurements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.35761589403974%\" colspan=\"17\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eyear\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.744186046511628%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGross motor function\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eGMFCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eGMFM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper limb motor function\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eMACS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eMini-MACS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eMA2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eBox and Block test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eSCUES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCognition and communication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eWISC-IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eWPPSI-IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eCFCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEating and Drinking Ability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eEDACS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eMini-EDACS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuality of life and social life ability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003ePedsQL\u0026nbsp;3.0 CP\u0026nbsp;Module\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003esocial life ability scale for Chinese infant\u0026ndash;junior school students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBehavior\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eConners\u0026apos;\u0026nbsp;parent\u0026nbsp;rating\u0026nbsp;scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNutritional status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eHeight and weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePain and sleep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eVisual analog scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eFaces pain rating scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eSleep disturbance scale for children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMuscle tone and contracture\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n 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\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eModified Ashworth scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n 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\u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68988391376451%\" valign=\"top\"\u003e\n \u003cp\u003eRange of motion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.648424543946932%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8092868988391375%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026radic;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eGMFCS: Gross motor function classification system; GMFM:\u0026nbsp;Gross motor function measurement;\u0026nbsp;MACS: Manual Ability Classification System;\u0026nbsp;MA2:\u0026nbsp;The Melbourne Assessment of Unilateral Upper Limb Function; SCUES:\u0026nbsp;Selective Control of the Upper Extremity Scale; WISC-IV: Wechsler Intelligence Scale for Children-fourth edition;\u0026nbsp;WPPSI-IV:\u0026nbsp;Wechsler Preschool and Primary Scale of Intelligence-fourth Edition; CFCS:\u0026nbsp;Communication Function Classification System; EDACS: Eating and Drinking Ability Classification System;\u0026nbsp;PedsQL:\u0026nbsp;Pediatric Quality of Life Inventory.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"cerebral palsy, children, functional developmental trends, genetic etiology, imaging examination, cohort protocol.","lastPublishedDoi":"10.21203/rs.3.rs-3996459/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3996459/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003eCerebral palsy (CP) is the most common physical disability in children, which brings heavy economic and mental burden to families and society. Nowadays, the clinical management of CP faces with huge challenge due to the unsatisfactory therapeutic effects and the enormous heterogeneity in etiology and clinical manifestations. This study aims to investigate the functional changes and the influential factors of Chinese children with CP, and elucidate the characteristic of brain structure and genetic etiology, thus to provide solutions for the prevention and treatment of children with CP and the decision-making of health management in this group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods and analysis: \u003c/strong\u003eThis prospective cohort study aims to recruit 1547 children with CP in China. Participants will receive basic information investigation (such as birth history, family history and comorbidities), functional assessments (gross and fine motor function, cognitive and linguistic function, quality of life, social life ability, eating and drinking ability, behavior problems, sleep, pain and nutritional status) and regular follow-ups, whole-genome analysis, brain and musculoskeletal imaging examination. In addition, quality of life and emotional problems will be analysed for caregivers. Correlation analysis, logistic regression binary or multivariate logistic regression, linear/non-linear mixed-effects regression models and structural-equation models will be conducted in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion: \u003c/strong\u003eThis study will observe the functional changes and their risk factors in children with CP their caregivers. Plus, the pathogenic genes and imaging features will be explored in this study. These will help understand the the progression of disease changes in children with CP and the impact of the targeted disease on caregivers. Also, more new and valuable evidence about etiology of CP will be unveiled.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration: \u003c/strong\u003eThe study protocol (2023-12-22) has been registered with the Chinese Clinical Trial Registry (NO. ChiCTR2300079017).\u003c/p\u003e","manuscriptTitle":"Longitudinal cohort protocol study of children with cerebral palsy in China: functional developmental trends, genetic etiology and imaging features of brain","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-05 16:39:31","doi":"10.21203/rs.3.rs-3996459/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"58e8385a-98b3-4198-a4a2-b61ff6d4b400","owner":[],"postedDate":"March 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-12T12:21:59+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-05 16:39:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3996459","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3996459","identity":"rs-3996459","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}