Functional profiles of children with cerebral palsy in Jordan based on the association between gross motor function and manual ability

Abstract

BackgroundCerebral palsy (CP) is the most common cause of physical disability in childhood. A major challenge for delivering effective services for children with CP is the heterogeneity of the medical condition. Categorizing children into homogeneous groups based on functional profiles is expected to improve service planning. The aims of this study were to (1) to describe functional profiles of children with CP based on the Gross Motor Function Classification System-Expanded & Revised (GMFCS-E & R) and the Manual Ability Classification System (MACS); and (2) to examine associations and agreements between the GMFCS-E & R and the MACS for all participants then for subgroups based on subtypes of CP and chronological age of children.MethodsA convenience sample of 124 children with CP (mean age 4.5, SD 2.9 years, 56% male) participated in the study. Children were classified into the GMFCS-E & R and the MACS levels by research assistants based on parents input. Research assistants determined the subtypes of CP.ResultsThirty six percent of the participants were able to ambulate independently (GMFCS-E & R levels I-II) and 64% were able to handle objects independently (MACS levels I-II). The most common functional profile of children with CP in our study is the “manual abilities better than gross motor function”. An overall strong correlation was found between the GMFCS-E & R and the MACS (rs = .73, p < .001), the correlations vary significantly based on subtypes of CP and chronological age of children. A very strong correlation was found in children with spastic quadriplegia (rs = .81, p < .001), moderate with spastic diplegia (rs = .64, p < .001), and weak with spastic hemiplegia (rs = .37, p < .001).ConclusionsThe GMFCS- E & R and the MACS provide complementary but distinctive information related to mobility and manual abilities of children with CP. Subtypes of CP and chronological age differentiated functional profiles. Functional abilities of children with CP in Jordan have similar patterns to children with CP in other countries. Functional profiles can inform clinicians, researchers, and policy makers.

Children and adolescents with physical disabilities: describing characteristics and disability-related needs in the Kilimanjaro region, north-eastern Tanzania – a cross-sectional survey

“…Consistent with other research 43 44 cerebral palsy was the most common reported childhood diagnosis in this study. Cerebral palsy is a syndrome accompanied by movement disorders resulting from permanent damage to the developing brain which impairs mobility.…”

Epidemiology of Cerebral Palsy among Children and Adolescents in Arabic-Speaking Countries: A Systematic Review and Meta-Analysis

“…The 32 included studies were published between 1984 and 2020. Most of the studies were from Saudi Arabia ( n = 10) [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], Jordan ( n = 8) [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], Egypt ( n = 6) [ 47 , 48 , 49 , 50 , 51 , 52 ], and Iraq ( n = 4) [ 53 , 54 , 55 , 56 ]. Other studies were from Sudan ( n = 2) [ 57 , 58 ], Libya ( n = 1) [ 59 ], and Palestine ( n = 1) [ 60 ].…”

“…There were a variety of study designs. Most were of case-series ( n = 13) [ 32 , 33 , 34 , 36 , 38 , 40 , 41 , 42 , 43 , 44 , 53 , 55 , 56 ] and cross-sectional design ( n = 11) [ 29 , 31 , 39 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Other study designs included: case-control ( n = 5) [ 35 , 54 , 58 , 59 , 60 ], retrospective review ( n = 2) [ 37 , 57 ], and prospective/retrospective cohort ( n = 1) [ 30 ].…”

“… Forest plot (to the left) shows the pooled estimates % of GMFCS level I-III among children and adolescents with CP in ASCs [ 29 , 39 , 40 , 41 , 42 , 47 , 48 , 49 ]. Assessment of publication bias by Funnel plot (to the right) shows individual study estimates against corresponding standard errors (Kendall’s Tau = −0.5000, p = 0.0833).…”

Evaluation of Participation Level of Adolescents with Cerebral Palsy

“…And in practical settings, things may either improve or deteriorate with aging in such cases. 2 Cerebral palsy is a prevalent neurological problem in infants, occurring around 2-2.5 out of every 1000 live births globally 3 .…”