The relationship between spasticity and gross motor capability in nonambulatory children with spastic cerebral palsy

Abstract

Spasticity has been considered as a major impairment in cerebral palsy (CP), but the relationship between this impairment and motor functions is still unclear, especially in the same group of patients with CP. The aim of this investigation is to determine the relationship between spasticity and gross motor capability in nonambulatory children with spastic CP. Seventy-one children (30 boys, 41 girls) with bilateral spastic cerebral palsy and with Gross Motor Function Classification System (GMFCS) levels IV (n=34) and V (n=37) were included in the study. The spasticity level in lower limbs was evaluated using the Modified Modified Ashworth Scale and the gross motor function with the Gross Motor Function Measure (GMFM-88). Spearman's correlation analysis was used to determine the nature and the strength of the relationship. The results showed a moderate correlation between spasticity and gross motor skills (ρ=0.52 for the GMFCS level; ρ=0.57 for the GMFM-88), accounting for less than 30% of the explained variance. It seems that spasticity is just one factor among many others that could interfere with gross motor skills, even in children with severe forms of spastic CP. Knowledge of the impact of spasticity on motor skills may be useful in the setting of adequate rehabilitation strategies for nonambulatory children with spastic CP.

IncobotulinumtoxinA for the treatment of lower-limb spasticity in children and adolescents with cerebral palsy: A phase 3 study1

“…Spasticity is just one factor among many others that could interfere with gross motor development [ 60 ], even in children with severe forms of spastic CP. For instance, strength (impaired by the underlying paresis) [ 61 ] and selective motor control [ 62 ] have also been found to be contributory.…”

Selective dorsal rhizotomy: short-term results and early experiences with a newly established surgical treatment in Slovenia

“…The SDR is mostly suitable for children with spastic diplegia classified with GMFCS 2 or 3. These children are able to walk, or, at least, they have a potential for improvement of the lower limb motility [21][22][23]. In low degrees of spasticity (GMFCS 1), the daily activities are not disturbed to such degree, that the operation would bring any relevant relief, as with higher grades.…”

Зміни рухових функцій у дітей iз церебральним паралічем після курсу інтенсивної нейрофізіологічної реабілітації: сліпе дослідження

“…The difference in PROM measurements is associated with statistically significant changes in spasticity, detected in the lower extremity muscle groups (Table 4). As spasticity is a factor that directly affects acquisition of new motor skills, even subtle reduction of spasticity is beneficial for patients with cerebral palsy [20].…”