Self‐care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications

Abstract

AIM The aim of this study was to investigate the acquisition of self-care and mobility skills in children with cerebral palsy (CP) in relation to their manual ability and gross motor function.METHOD Data from the Pediatric Evaluation of Disability Inventory (PEDI) self-care and mobility functional skill scales, the Manual Ability Classification System (MACS), and the Gross Motor Function Classification System (GMFCS) were collected from 195 children with CP (73 females, 122 males; mean age 8y 1mo; SD 3y 11mo; range 3-15y); 51% had spastic bilateral CP, 36% spastic unilateral CP, 8% dyskinetic CP, and 3% ataxic CP. The percentage of children classified as MACS levels I to V was 28%, 34%, 17%, 7%, and 14% respectively, and classified as GMFCS levels I to V was 46%, 16%, 15%, 11%, and 12% respectively. RESULTS Children classified as MACS and GMFCS levels I or II scored higher than children inMACS and GMFCS levels III to V on both the self-care and mobility domains of the PEDI, with significant differences between all classification levels (p<0.001). The stepwise multiple regression analysis verified that MACS was the strongest predictor of self-care skills (66%) and that GMFCS was the strongest predictor of mobility skills (76%). A strong correlation between age and self-care ability was found among children classified as MACS level I or II and between age and mobility among children classified as GMFCS level I. Many of these children achieved independence, but at a later age than typically developing children. Children at other MACS and GMFCS levels demonstrated minimal progress with age.

Comprehension of spoken language in non‐speaking children with severe cerebral palsy: an explorative study on associations with motor type and disabilities

“…Although a strong relation has been shown between the higher MACS and GMFCS levels, 25,26 more studies are needed on MACS levels in relation to language comprehension performance.…”

A Randomised Controlled Study to Investigate Effects of Bobath Based Trunk Control Training on Motor Function of Children with Spastic Bilateral Cerebral Palsy

“…Because of the lack of movement ability, children with CP spend more energy compared to the same aged healthy children. Due to muscle tone abnormalities, muscle weaknesses, trunk control difficulties and skeletal deformities children with CP are spending up to 2 -3 times more energy compared to the same aged healthy children during a sub maximal exercise [5] [6] [7].…”

Current understanding of the factors influencing the functional independence of people with cerebral palsy: a review of the literature

“…around the seventh year of life (Ohrvall et al, 2010). It has been suggested that the age of 6-7 years is the upper limit for the development of new basic motor skills (Harries et al, 2004;Manikowska et al, 2009) and that by the age of 5 years children have attained 90% of their final functional skills (Manikowska et al, 2009;Natroshvili et al, 2005).…”

“…Readers wanting to become more thoroughly acquainted with those scales should refer to suitable literature Grimby, 2004a, 2004b;Barlett and Palisano, 2000;Cavallo et al, 2009;Chiarello et al, 2010;Donkervoort et al, 2007;Gonzalez-Heydrich et al, 2007;Gut and Jabłoński, 2011;Harrison and Oakland 2003;Krigger, 2006;Margre et al, 2010;Michalska et al, 2012;Ohrvall et al, 2010;Østensjø, Carlberg and Vøllestad, 2003;Østensjø et al, 2004;Østensjø et al, 2005;Sienkiewicz et al, 2009;Tarsuslu and Livanelioglu, 2010;Van Eck et al, 2009;Van Eck et al, 2010;Wong et al, 2004). Krigger, 2006;Margre et al, 2010;Ohrvall et al, 2010;Østensjø et al, 2004;Østensjø et al, 2005;Sienkiewicz et al, 2009;Tarsuslu and Livanelioglu, 2010). This scale categorizes an individual's motor functionality according to demonstrated motor skills and age.…”