A multivariate model of determinants of motor change for children with cerebral palsy

The purpose of this article is to describe the development of a theory and data-based model of determinants of motor change for children with cerebral palsy. The dimensions of human functioning proposed by the World Health Or ganization, general systems theory, theories of human ecology, and a philos ophical approach incorporating family-centered care provide the conceptual framework fur the model. The model focuses on relationships among child cha racteristics leg, primary and secondary impairments, personality), family e cology leg, dynamics of family function), and health care services (eg, ava ilability, access, intervention options). Clarification of the complex mult ivariate and interactive relationships among the multiple child and family determinants, using statistical methods such as structural equation modelin g, is necessary before determining how physical therapy intervention can op timize motor outcomes of children with cerebral palsy. MTC propose that the development and. testing of multivariate models is also useful in physical therapy research and in the management of complex chronic conditions other than cerebral palsy. Testing of similar models could provide physical ther apists with support for: (1) prognostic discussions with clients and their families, (2) establishment of realistic and attainable goals, and (3) inte rventions to enhance outcomes for individual clients with a variety of prog nostic attributes.