Relationship Between Gross Motor Function and Daily Functional Skill in Children With Cerebral Palsy

Abstract

ObjectiveTo investigate the relationship between gross motor function and daily functional skill in children with cerebral palsy (CP) and to explore how this relationship is moderated by the Gross Motor Function Classification System, Bimanual Fine Motor Function (BFMF), neuromotor types, and limb distribution of CP.MethodsA cross-sectional survey of 112 children with CP (range, 4 years to 7 years and 7 months) was performed. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and functional skill was assessed with the Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS).ResultsGMFM-66 scores explained 49.7%, 67.4%, and 26.1% of variance in the PEDI-FSS scores in the self-care, mobility, and social function domains, respectively. Significant moderation by the distribution of palsy and BFMF classification levels II, III, and IV was found in the relationship between GMFM-66 and PEDI-FSS self-care. Further significant moderation by the distribution of palsy was also observable in the relationship between GMFM-66 and PEDI-FSS mobility.ConclusionThese findings suggest that limb distribution and hand function must be considered when evaluating gross motor function and functional skills in children with CP, especially in unilateral CP.

Effects of Hippotherapy on Gross Motor Function and Functional Performance of Children with Cerebral Palsy

“…The social functioning domain is influenced by various factors such as education, socioeconomic status, cognition, communication abilities and motor function. 27 The opportunity to use or practice communication, listening and language skills during hippotherapy may have resulted in the improvements observed in PEDI social functioning, in line with Casady and Nichols-Larsen's 11 report.…”

“…These findings suggest some positive effects of hippotherapy on the child's actual performance in daily life. The mobility domain is closely related to gross motor function based on GMFCS level, 27 while the self-care domain is related to both GMFCS level and hand function based on Manual Ability Classification System score. 28 According to a previous report, hippotherapy improved dynamic trunk stability and functional reach in children with spastic diplegia.…”

Motor abilities, activities, and participation of institutionalized Brazilian children and adolescents with cerebral palsy

“…The children and adolescents at the institution had severe impairments in fine hand use (d440), compromising activities such as toileting (d530) and eating (d550). In fact, for Kwon, Yi, Kim, Chang, Kwon 34 and Brandão, Ocarino, Bueno, Mancini 41 , hand use in CP is strongly related to self-care. Experimental studies with rats have shown that hand use increases the flow of nerve impulses in the dendrites, with remodeling of neuronal circuits after fine motor stimuli 37 .…”

Funcionalidade em Atividades de Vida Diária de Crianças Deambuladoras com Paralisia Cerebral

“…Essa relação entre melhor GMFCS e desempenho funcional é esperada, na existência de padrões cognitivos semelhantes, e assim apresentam melhor repertório funcional em atividades de vida diária 14,17 Com as curvas fornecidas por Rosenbaum et al 18 Crianças com PC, quando comparadas com às típicas, apresentam mais dificuldade em atividades que envolvem características específicas de função manual (como função bimanual) como colocar e retirar roupa, abotoar e desabotoar, dentre outras), com dificuldades também no controle postural para executar tais atividades [22][23][24] .…”