scholarly journals Assessment of the Relationship between Hamstring Tightness and Pelvic Tilt in Cerebral Palsy: Are We Overdoing Hamstring Releases in Children with Spastic Bilateral CP, GMFCS Level I-III?

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Mohamed Mohamed Tageldeen ◽  
Bahassan Salmeen Awad Salmeen ◽  
Diab Nader M ◽  
Barakat Ahmed Samir
Keyword(s):  
Cerebral Palsy ◽  
Pelvic Tilt ◽  
Level I ◽  
The Relationship ◽  
Gmfcs Level

scholarly journals Reliability and Validity of Data for 2 Newly Developed Shuttle Run Tests in Children With Cerebral Palsy

2006 ◽  
Vol 86 (8) ◽  
pp. 1107-1117 ◽  
Author(s):  
Olaf Verschuren ◽  
Tim Takken ◽  
Marjolijn Ketelaar ◽  
Jan Willem Gorter ◽  
Paul JM Helders
Keyword(s):  
Cerebral Palsy ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Treadmill Test ◽  
Children With Cerebral Palsy ◽  
Level I ◽  
Test Retest Reliability ◽  
Shuttle Run ◽  
Gmfcs Level

Abstract Background and Purpose. The purpose of this study was to examine the reliability and validity of data obtained with 2 newly developed shuttle run tests (SRT-I and SRT-II) to measure aerobic power in children with cerebral palsy (CP) who were classified at level I or II on the Gross Motor Function Classification System (GMFCS). The SRT-I was developed for children at GMFCS level I, and the SRT-II was developed for children at GMFCS level II. Subjects. Twenty-five children and adolescents with CP (10 female, 15 male; mean age=11.9 years, SD=2.9), classified at GMFCS level I (n=14) or level II (n=11), participated in the study. Methods. To assess test-retest reliability of data for the 10-m shuttle run tests, the subjects performed the same test within 2 weeks. To examine validity, the shuttle run tests were compared with a GMFCS level–based treadmill test designed to measure peak oxygen uptake. Results. Statistical analyses revealed test-retest reliability for exercise time (number of levels completed) (intraclass correlation coefficients of .97 for the SRT-I and .99 for the SRT-II) and reliability for peak heart rate attained during the final level (intraclass correlation coefficients of .87 for the SRT-I and .94 for the SRT-II). High correlations were found for the relationship between data for both shuttle run tests and data for the treadmill test (r=.96 for both). Discussion and Conclusion. The results suggest that both 10-m shuttle run tests yield reliable and valid data. Moreover, the shuttle run tests have advantages over a treadmill test for children with CP who are able to walk and run (GMFCS level I or II). [Verschuren O, Takken T, Ketelaar M, et al. Reliability and validity of data for 2 newly developed shuttle run tests in children with cerebral palsy. Phys Ther. 2006;86:1107–1117.]

scholarly journals Reference Values for Aerobic Fitness in Children, Adolescents, and Young Adults Who Have Cerebral Palsy and Are Ambulatory

2010 ◽  
Vol 90 (8) ◽  
pp. 1148-1156 ◽  
Author(s):  
Olaf Verschuren ◽  
Manon Bloemen ◽  
Cas Kruitwagen ◽  
Tim Takken
Keyword(s):  
Young Adults ◽  
Cerebral Palsy ◽  
Young People ◽  
Reference Values ◽  
Aerobic Fitness ◽  
Adolescents And Young Adults ◽  
Cross Sectional ◽  
Level I ◽  
Shuttle Run ◽  
Gmfcs Level

BackgroundVery few objective data exist regarding aerobic performance in young people with cerebral palsy (CP). The characterization of aerobic fitness could provide baseline and outcome measures for the rehabilitation of young people with CP.ObjectiveThe objective of this study was to provide reference values for aerobic fitness in a group of children, adolescents, and young adults who had CP and who were classified at Gross Motor Function Classification System (GMFCS) level I or II. Data were collected with 10-m shuttle run tests.DesignThis investigation was a cross-sectional observational study conducted between August 2008 and June 2009.MethodsReference values were established using data from a total of 306 children, adolescents, and young adults who had CP, who were 6 to 20 years old, and who were recruited from 26 rehabilitation centers in the Netherlands, Switzerland, Australia, Canada, and the United States. A total of 211 participants were classified at GMFCS level I (mean age=12.2 years, SD=3.0), and 95 were classified at GMFCS level II (mean age=12.4 years, SD=3.2); 181 were male, and 125 were female. Aerobic fitness was reflected by the level achieved on the 10-m shuttle run tests.ResultsOn the basis of a total of 306 assessments from the 10-m shuttle run tests, 4 reference curves were created.LimitationsThe limitation of this study is the cross-sectional nature of the design.ConclusionsThis study provided height-related reference values for aerobic fitness in children, adolescents, and young adults who had CP, who were 6 to 20 years old, and who were classified at GMFCS level I or II. Generalized additive models for location, scale, and shape were used to construct centile curves. These curves are clinically relevant and provide a user-friendly method for the prediction of aerobic fitness in young people with CP.

scholarly journals Inclusion of children with cerebral palsy in basic education

2014 ◽  
Vol 21 (1) ◽  
pp. 40-46
Author(s):  
Geovana Sôffa Rézio ◽  
Cibelle Kayenne Martins Roberto Formiga
Keyword(s):  
Cerebral Palsy ◽  
School Environment ◽  
Basic Education ◽  
Gross Motor ◽  
Rehabilitation Centers ◽  
School Participation ◽  
Children With Cerebral Palsy ◽  
Level I ◽  
Function Assessment ◽  
Gmfcs Level

The aim of the study was to analyze the inclusion of children with cerebral palsy in elementary schools. The sample consisted of 31 children between 1 and 11 years old, with a mean of 5 years and 2 months, coming from 2 rehabilitation centers and their leaders and teachers. As for functionality, 71% are Gross Motor Function Classification System (GMFCS) level I, 51.6% are diplegic and 58.1% had cerebral palsy during the prenatal stage. Regarding economic classification, 54.8% of the families were in class C. A neurological evaluation form was applied. A gross motor evaluation using the GMFCS; a socioeconomic assessment using the Brazilian Criteria for Economic Classification and the School Function Assessment were done. The results revealed that these children perform their activities in all aspects of the school participation, although they require constant supervision, moderate assistance and minimal adaptation. These results may be useful to better adapt the school environment, for a better targeting of assistance provided and to plan clinical interventions with these children.

Test–Retest Reliability and Construct Validity of the German Translation of the Gait Outcome Assessment List (GOAL) Questionnaire for Children with Ambulatory Cerebral Palsy

2021 ◽  
Author(s):  
Michaela V. Bonfert ◽  
Evelyn Jelesch ◽  
A. Sebastian Schroeder ◽  
Julia Hartmann ◽  
Helene Koenig ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Motor Function ◽  
Related Function ◽  
Retest Reliability ◽  
Level Ii ◽  
Children With Cerebral Palsy ◽  
Level I ◽  
Test Retest Reliability ◽  
Gmfcs Level

AbstractThe Gait Outcome Assessment List (GOAL) is a patient or caregiver-reported assessment of gait-related function across different domains of the International Classification of Functioning, Disability, and Health (ICF) developed for ambulant children with cerebral palsy (CP). So far, the questionnaire is only available in English. The aim of this study was to translate the GOAL into German and to evaluate its reliability and validity by studying the association between GOAL scores and gross motor function as categorized by the gross motor function classification system (GMFCS) in children with cerebral palsy (CP). The GOAL was administered to primary caregivers of n = 91 children and adolescents with CP (n = 32, GMFCS levels I; n = 27, GMFCS level II; and n = 32, GMFCS level III) and n = 15 patients were capable of independently completing the whole questionnaire (GMFCS level I). For assessing test–retest reliability, the questionnaire was completed for a second time 2 weeks after the first by the caregivers of n = 36 patients. Mean total GOAL scores decreased significantly with increasing GMFCS levels with scores of 71 (95% confidence interval [CI]: 66.90–74.77) for GMFCS level I, 56 (95% CI: 50.98–61.86) for GMFCS level II, and 45 (95% CI: 40.58–48.48) for GMFCS level III, respectively. In three out of seven domains, caregivers rated their children significantly lower than children rated themselves. The test–retest reliability was excellent as was internal consistency given the GOAL total score. The German GOAL may serve as a much needed patient-reported outcome measure of gait-related function in ambulant children and adolescents with CP.

scholarly journals Change in popliteal angle and hamstrings spasticity during childhood in ambulant children with spastic bilateral cerebral palsy. A register-based cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Merete Aarsland Fosdahl ◽  
Reidun Jahnsen ◽  
Are Hugo Pripp ◽  
Inger Holm
Keyword(s):  
Cerebral Palsy ◽  
Cohort Study ◽  
Level Ii ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Second Year ◽  
Level I ◽  
Ashworth Scale ◽  
Gmfcs Level

Abstract Background Muscle contractures are developing during childhood and may cause extensive problems in gait and every day functioning in children with cerebral palsy (CP). The aim of the present study was to evaluate how the popliteal angle (PA) and hamstrings spasticity change during childhood in walking children with spastic bilateral CP. Methods The present study was a longitudinal register-based cohort study including 419 children (1–15 years of age) with spastic bilateral CP, gross motor function classification system (GMFCS) level I, II and III included in the Norwegian CP Follow-up Program (CPOP). From 2006 to 2018 a total of 2193 tests were performed. The children were tested by trained physiotherapists yearly or every second year, depending on GMFCS level and age. The PA and the hamstrings spasticity (Modified Ashworth scale (MAS)) were measured at every time point. Both legs were included in the analysis. Results There was an increase in PA with age for all three GMFCS levels with significant differences between the levels from 1 up to 8 years of age. At the age of 10 years there was no significant difference between GMFCS level II and III. At the age of 14 years all three GMFCS levels had a mean PA above 40° and there were no significant differences between the groups. The hamstrings spasticity scores for all the three GMFCS levels were at the lower end of the MAS (mean < 1+), however they were significantly different from each other until 8 years of age. The spasticity increased the first four years in all three GMFCS levels, thereafter the level I and II slightly increased, and level III slightly decreased, until the age of 15 years. Conclusion The present study showed an increasing PA during childhood. There were significantly different PAs between GMFCS level I, II and III up to 8 years of age. At the age of 14 years all levels showed a PA above 40°. The spasticity increased up to 4 years of age, but all the spasticity scores were at the lower end of the MAS during childhood.

scholarly journals Self-versus Proxy-Reported Pain in Children with Cerebral Palsy: A Population-Based Registry Study of 3783 Children

2020 ◽  
Vol 11 ◽  
pp. 215013272091152 ◽  
Author(s):  
Gunnar Hägglund ◽  
Amanda Burman-Rimstedt ◽  
Tomasz Czuba ◽  
Ann I. Alriksson-Schmidt
Keyword(s):  
Logistic Regression ◽  
Cerebral Palsy ◽  
Classification System ◽  
Population Based ◽  
Registry Study ◽  
Cross Sectional ◽  
Marginal Effects ◽  
Level I ◽  
Average Marginal Effects ◽  
Gmfcs Level

Objective: To assess how the prevalence of pain in a population-based sample of children and adolescents with cerebral palsy (CP) differ based on self- or proxy reporting. Methods: This cross-sectional registry study included 3783 children (58% boys), 1 to 18 years old, enrolled in the Swedish follow-up program for CP. Logistic regression was used to regress source of reporting (self or proxy) on the presence of general pain adjusted for age, sex, Gross Motor Function Classification System (GMFCS), and Communication Function Classification System (CFCS) levels, including marginal effects between source of reporting and adjusted covariates. Results: The pain item was self-reported in 45%, proxy-reported in 51%, and information was missing in 3%. Pain was reported in 44% of those who self-reported and in 41% of those who proxy-reported ( P = .04). The logistic regression showed that the average marginal effects of proxy versus self-reported pain were lower among children at GMFCS level IV (−0.14, 95% CI −0.17 to −0.03) and CFCS level I (−0.09, CI −0.16 to −0.01) and higher at CFCS level III (0.11, CI 0.00-0.22). There were no statistically significant differences in average marginal effects related to age, sex, or the other GMFCS and CFCS levels between proxy and self-reporting. Conclusions: Pain was more often reported by those who self-reported. However, after adjusting for age, sex, CFCS level, and GMFCS level, the proportion of reported pain was almost equal between self and proxy-reporting. Assuming that the self- and proxy-reported groups were not significantly different on relevant factors not controlled for the results indicate that presence of pain is equally reported by children and parents.

scholarly journals Radiological hip indices correlate with GMFCS level I and GMFM-66 scores in cerebral palsy

2019 ◽  
Vol 13 (1) ◽  
pp. 13-20
Author(s):  
Özlem ELVAN ◽  
Mert KESKİNBORA ◽  
Havva Didem ÇELİKCAN ◽  
Alev BOBUŞ ◽  
Anıl ÖZGÜR ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Level I ◽  
Gmfcs Level

Social and Community Participation of Children and Youth With Cerebral Palsy Is Associated With Age and Gross Motor Function Classification

2009 ◽  
Vol 89 (12) ◽  
pp. 1304-1314 ◽  
Author(s):  
Robert J. Palisano ◽  
Lin-Ju Kang ◽  
Lisa A. Chiarello ◽  
Margo Orlin ◽  
Donna Oeffinger ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Community Participation ◽  
Motor Function ◽  
Structured Interview ◽  
Children And Youth ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Level I ◽  
Gmfcs Level

Background Through social and community participation, children and youth with cerebral palsy (CP) form friendships, gain knowledge, learn skills, express creativity, and determine meaning and purpose in life. Objective The purposes of this study were: (1) to determine whether social and community participation of children and youth with CP differ based on age, sex, and gross motor function, and (2) to identify the types of activities in which social and community participation are highest. Design and Methods A prospective cross-sectional analytic design was used. The participants were a sample of convenience of 291 children (6–12 years of age) and 209 youth (13–21 years of age) with CP (55.4% males, 44.6% females) receiving services from 7 children's hospitals. Participants completed the Children's Assessment of Participation and Enjoyment (CAPE) by structured interview. Gross Motor Function Classification System (GMFCS) level was determined by the researchers. Results Youth did a higher percentage of activities with friends and others and outside the home than children. Children and youth in level I did a higher percentage of activities with friends and others compared with children and youth in levels II and III and in levels IV and V. Children and youth in level I and in levels IV and V did a higher percentage of activities outside the home than children and youth in levels II and III. Differences were not found between females and males. The percentage of activities done with friends and others and outside the home was highest for physical and skill-based activities. Limitations Findings cannot be attributed only to GMFCS level. Conclusions The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments.

scholarly journals Impact of a virtual reality-based intervention on motor performance and balance of a child with cerebral palsy: a case study

2014 ◽  
Vol 32 (4) ◽  
pp. 389-394 ◽  
Author(s):  
Silvia Leticia Pavão ◽  
Joice Luiza Bruno Arnoni ◽  
Alyne Kalyane Câmara de Oliveira ◽  
Nelci Adriana Cicuto Ferreira Rocha
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Motor Development ◽  
Motor Performance ◽  
Promising Tool ◽  
Hemiplegic Cerebral Palsy ◽  
Intervention Protocol ◽  
Level I ◽  
Gmfcs Level

OBJECTIVE: To verify the effect of an intervention protocol using virtual reality (VR) on the motor performance and balance of a child with cerebral palsy (CP).CASE DESCRIPTION: To comply with the proposed objectives, a 7-year old child with spastic hemiplegic cerebral palsy (CP), GMFCS level I, was submitted to a physiotherapy intervention protocol of 12 45-minute sessions, twice a week, using virtual reality-based therapy. The protocol used a commercially-available console (XBOX(r)360Kinect(r)) able to track and reproduce body movements on a screen. Prior to the intervention protocol, the child was evaluated using the Motor Development Scale (MDS) and the Pediatric Balance Scale (PBS) in order to assess motor development and balance, respectively. Two baseline assessments with a 2-week interval between each other were carried out for each tool. Then, the child was re-evaluated after the twelfth session. The results showed no changes in the two baseline scores. After the intervention protocol, the child improved his scores in both tools used: the PBS score increased by 3 points, reaching the maximal score, and the MDS increased from a much inferior motor performance to just an inferior motor performance.COMMENTS: The evidence presented in this case supports the use of virtual reality as a promising tool to be incorporated into the rehabilitation process of patients with neuromotor dysfunction.

scholarly journals Factors Influencing Motor Outcome of Hippotherapy in Children with Cerebral Palsy

2019 ◽  
Vol 50 (03) ◽  
pp. 170-177 ◽  
Author(s):  
Yeo Seung Mi ◽  
Lee Ji Young ◽  
Shin Hye Yeon ◽  
Seo Yun Sik ◽  
Kwon Jeong Yi
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Factors Influencing ◽  
Children With Cerebral Palsy ◽  
Motor Outcome ◽  
Level I ◽  
Gmfcs Level

Objective This study was aimed to identify individual factors influencing the gross motor outcome of hippotherapy in children with cerebral palsy (CP). Methods One hundred and forty-six children with CP (mean age: 5.78 ± 1.72 years, male: 56.2%) presenting variable function (gross motor function classification system [GMFCS], levels I–IV) participated in this study. Participants received 30 minutes of hippotherapy twice a week for 8 weeks. Clinical information including GMFCS level, age, sex, CP distribution, CP type, gross motor function measure-88 (GMFM-88), GMFM-66, and pediatric balance scale (PBS) score were collected retrospectively. We regarded the children with GMFM-66 score increased by 2.0 points as good responders to hippotherapy. Further we analyzed factors affecting good responders. Results GMFCS level I and II compared with IV (odds ratio [OR] = 6.83) and III compared with IV (OR = 4.45) were significantly associated with a good response to hippotherapy. Higher baseline GMFM E (OR = 1.05) and lower baseline GMFM B (OR = 0.93) were also significantly associated with a good response to hippotherapy. Sex, age, CP type, and distribution were not factors influencing gross motor outcome of hippotherapy. Conclusions The children with CP, GMFCS level I–III, with relatively poor postural control in sitting might have a greater chance to improve their GMFM-66 scores through hippotherapy. This supports the hypothesis that hippotherapy is a context-focused therapy to improve postural control in sitting.

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