Shraddha Diwan1, Jasmin Diwan2, Ankita B Bansal3, Pankaj R Patel4. 1. Lecturer, Department of Paediatrics Physiotherapy, S.B.B College of Physiotherapy, VS Hospital , Ahmedabad, Gujarat, India . 2. Professor & Head, Department of Physiology, GMERS Medical College, Civil Hospital , Gandhinagar, Gujarat, India . 3. MPT Neurology, Department of Paediatrics Physiotherapy, S.B.B College of Physiotherapy , Ahmedabad, Gujarat, India . 4. Dean & Professor, Department of Orthopaedics, Smt. NHL Municipal Medical College, V S Hospital , Ahmedabad, Gujarat, India .
Abstract
BACKGROUND: Children with cerebral palsy, although having similar diagnosis, varies in their abilities & level of functioning within & across different environmental context e.g. home, school or community setting. Capacity (what a child can do in standardized, controlled environment) may or may not be the same as performance (what a child actually does do in her/her daily environment). MATERIALS AND METHODS: After getting approval from Institutional Ethic's Committee (IEC), 63 children with cerebral palsy (4-16 year, mean 7.4 year with SD 0.39) of all clinical types, Gross Motor Functional Classification System (GMFCS) level I-V were examined for mobility using Gross Motor Functional Measure 88 (GMFM). Motor capacity was assessed in clinical setting by highest of 3 GMFM items attained, i.e., crawling (44), walks with support (68) & walks without support (70). Motor performance was measured by Functional Mobility Scale version 2. RESULT: On analysis of motor capacity 42.85% children were walking without support, 15.87% were able to crawl & 26.98% were able walk with support in clinical setting. Spearman's Correlation was done between GMFM item 70 with FMS 5 (home setting) to check correlation of capacity with performance & was found to be significantly correlated (r=0.586, p=0.04). All three GMFM items were correlated with FMS 5, 50, 500 & found positively correlated. For community setting (FMS 500), 52.38% children were lifted by parents & only 6.34% were using wheel chair mobility. A total of 21.87% patients were able to walk with or without support & still lifted by parents in school or community setting. CONCLUSION: Change in capacity and performance of mobility exists mainly in school and community setting in studied population. Context should be given importance to prioritize rehabilitation process.
BACKGROUND:Children with cerebral palsy, although having similar diagnosis, varies in their abilities & level of functioning within & across different environmental context e.g. home, school or community setting. Capacity (what a child can do in standardized, controlled environment) may or may not be the same as performance (what a child actually does do in her/her daily environment). MATERIALS AND METHODS: After getting approval from Institutional Ethic's Committee (IEC), 63 children with cerebral palsy (4-16 year, mean 7.4 year with SD 0.39) of all clinical types, Gross Motor Functional Classification System (GMFCS) level I-V were examined for mobility using Gross Motor Functional Measure 88 (GMFM). Motor capacity was assessed in clinical setting by highest of 3 GMFM items attained, i.e., crawling (44), walks with support (68) & walks without support (70). Motor performance was measured by Functional Mobility Scale version 2. RESULT: On analysis of motor capacity 42.85% children were walking without support, 15.87% were able to crawl & 26.98% were able walk with support in clinical setting. Spearman's Correlation was done between GMFM item 70 with FMS 5 (home setting) to check correlation of capacity with performance & was found to be significantly correlated (r=0.586, p=0.04). All three GMFM items were correlated with FMS 5, 50, 500 & found positively correlated. For community setting (FMS 500), 52.38% children were lifted by parents & only 6.34% were using wheel chair mobility. A total of 21.87% patients were able to walk with or without support & still lifted by parents in school or community setting. CONCLUSION: Change in capacity and performance of mobility exists mainly in school and community setting in studied population. Context should be given importance to prioritize rehabilitation process.
Authors: Robert J Palisano; Beth L Tieman; Stephen D Walter; Doreen J Bartlett; Peter L Rosenbaum; Diane Russell; Steven E Hanna Journal: Dev Med Child Neurol Date: 2003-02 Impact factor: 5.449
Authors: Beth Tieman; Robert J Palisano; Edward J Gracely; Peter Rosenbaum; Lisa A Chiarello; Margaret O'Neil Journal: Phys Occup Ther Pediatr Date: 2004 Impact factor: 2.360
Authors: Adrienne Harvey; Richard Baker; Meg E Morris; Janet Hough; Marty Hughes; H Kerr Graham Journal: Dev Med Child Neurol Date: 2009-06-22 Impact factor: 5.449