The Correlation Of Types, Gross Motor Function And Accompanying Impairments In Children With Cerebral Palsy And The Impacts On Daily Living Activities

Cerebral palsy (cerebral palsy, CP), is a group of syndromes which leads to developmental disorders of movement and postures. It is also one of the common course of children with disabilities. Previous studies on cerebral palsy are more concentrated in motor function, gait and posture, muscle strength and muscle tone areas. Influenced by WHO’s publication," International Classification of Functioning, Disability and Health-Child and Adolescent Edition " (International Classification of Functioning, Disability and Health-Child and Youth version, under ICF) recent international studies on cerebral palsy have made a lot new achievements and studies began to pay more attention to the patients group. Those studies paid particular emphasis on the assessment of daily living activities, the impact on the involvement level of daily lives brought by the structure and function of the body, the environment and individual factors. At present, domestic research on this area is still very limited. And the aim of this paper is to analyze the impact on daily living activities caused by the type of cerebral palsy, the level of gross motor function and the relevance among associated impairments base on ICF framework.Objective:To study the the correlation of types, gross motor function and accompanying impairments in children with cerebral palsy and the impacts on daily living activities.Object:Data provided by the Scpchild cerebral palsy registration and management database showed that:between 2008.2-2012.11, cerebral palsy were documented in 79 children (53 males (57%),26 females (33%)). Patients were either diagnosed by Fudan University Children’s Hospital rehabilitation clinic or documented in three special schools with a age range within 1.42 to 16.92 years old. Among these data, patients with chronic disease beyond our research and who had received orthopedic surgery or after receiving the treatment of BTX-A and baclofen within six months have all be excluded.Method:All subjects were informed and agree to be recorded in Scpchild cerebral palsy registration and management database. All the selection on basic personal information, cerebral palsy types, gross motor function levels and common associated impairments were base on the database itself. Individual interviews on subjects’caregivers were carried out on Chinese version of the PEDI (Pediatric Evaluation of Disability Inventory). Scale scores were obtained via three dimensions, self-care activities in daily living, mobile and social function. All the scaled scores were analyzed in SPSS 19.0 Through Chi-square test, t test and multiple regression analysis which enabled us to have a view on the correlation among the type of cerebral palsy, function classification and associated impairments and their impact on daily living activities.Result:Part 1, the findings on the relevance among cerebral palsy types, gross motor function levels and associated impairments:1. GMFCS levels of different types of children with cerebral palsy have significant differences, among them:hemiplegia goes to GMFCS I and mild cerebral palsy calssified as GMFCSII; quadriplegia will be GMFCS IV and most of the severe cerebral palsy are graded at GMFCS V.2. For the children with cerebral palsy, the number of associated impairments increases the when GMFCS level raises. Multiple impairments numbers on GMFCS Ⅳ or Ⅴ children, who has severe cerebral palsy, are significantly higher the incidence of GMFCS I. The incidence of speech impairment increased significantly together with the GMFCS level and mental retardation cases among patients who had been graded with GMFCS IV-V were significantly higher than the patients within level Ⅰ-Ⅲ. There is no significant correlation between epilepsy, visual impairment and mobile function levels.3. Incidence of having multiple associated impairments on quadriplegia children were significantly higher than children with diplegia or hemiplegia. While quadriplegia children would also have a higher risk on having mental retardation and visual impairment than all the other types of cerebral palsy children. Incidence of occurring speech disorders in non-spastic cerebral palsy and quadriplegia children were significantly higher than diplegia and hemiplegia children. And there is no significant correlation between epilepsy and cerebral palsy types.Part 2, the results on the correlation among activities of daily lives for children with cerebral palsy:There was a high correlation among different fields of activities of daily lives, among them, ability to move and look after themselves had the highest correlation for children with cerebral palsy. Motor function classification and daily living activities score have direct correlation, the level of motor function decrease together with the activities of daily living; Multiple regression analysis also showed that:gross motor function has the most important effect on children with cerebral palsy; while age also has influence on three areas of daily life. Common associated impairments of cerebral palsy have partial impact on daily living activities.Conclusion:The correlation has been found among the level of gross motor function, the type of cerebral palsy and the correlation between associated impairments. Daily living capabilities are closely related to motor function level of children with cerebral palsy. Strengthen the training of motor function is the primary means for them to improve their daily living activities. Whilst, the management on cerebral palsy children in severe stage or those with multiple disabilities and associated impairments and correlation between associated impairments and different areas of daily living activities on cerebral palsy children are also crucial on improving the overall qualities of their daily life.