Investigation of Differences Between the Representatives of the High-to Moderate Functional Status According to Upper Limb Functions and Participation in Children with Congenital Hemiplegic Cerebral Palsy: A Cross-Sectional Study
Abstract
This study aimed to explore the acquisition of manual ability and participation performance in individuals with cerebral palsy (CP) in the context of classification systems. In other words, the aim was to determine whether the three representatives of functional status in individuals with CP differed according to manual ability and participation outcomes. Seventy-one individuals (mean 12.4 SD 2.3 years; 38 boys and 33 girls) diagnosed with CP were enrolled. The functional status of the study participants was defined using the Manual Ability Classification System (MACS), Gross Motor Function Classification System Expanded &Revised (GMFCS-E&R), and Communication Function Classification System (CFCS). Manual ability and participation outcomes were documented using the ABILHAND-Kids and Child and Adolescent Scales of Participation (CASP), respectively. Post-hoc tests demonstrated that individuals with high MACS and GMFCS-E&R levels had higher scores on the ABILHAND-Kids and CASP than those with low MACS and GMFCS-E&R levels (I>II>III, P<0.0001). Likewise, individuals in CFCS I scored better on both the ABILHAND-Kids and CASP than those in CFCS III (I>III, P<0.001). In contrast, ABILHAND-Kids and CASP scores were similar in individuals classified as CFCS I-II or CFCS II-III (P>0.05). Finally, multiple regression analyses revealed that MACS and GMFCS-E&R strongly predicted manual ability (MACS:65%; GMFCS-E&R: 23%) and participation outcomes (MACS: 46%-62%; GMFCS-E&R: 57%-68%). Knowledge from MACS and GMFCS-E&R can provide insight into the manual ability and participation outcomes of individuals with CP.
Keywords
References
- McConnell K, Johnston L, Kerr C. Upper limb function and deformity in cerebral palsy: a review of classification systems. Dev Med Child Neurol. 53(9):799-805. https://doi.org/ 10.1111/j.1469-8749.2011.03953. x.
- Gilmore R, Sakzewski L, Boyd R. Upper limb activity measures for 5‐to 16‐year‐old children with congenital hemiplegia: a systematic review. Dev Med Child Neurol. 52(1):14-21. https://doi.org/10.1111/j.1469-8749.2009.03369. x. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol Suppl. 2007; 49(6):480. PMID: 17370477.
- Eliasson AC, Krumlinde-Sundholm L, Rösblad B, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006; 48(7):549-54. https://doi.org/10.1017/S0012162206001162
- Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy. Children. 2017; 24;4(4):30. https://doi.org/10.3390/children4040030
- Öhrvall AM, Krumlinde-Sundholm L, Eliasson AC. Exploration of the relationship between the Manual Ability Classification System and hand-function measures of capacity and performance. Disabil Rehabi. 2013; 35(11):913-8. https://doi.org/10.3109/09638288.2012.714051
- Palisano RJ, Rosenbaum P, Bartlett D, et al. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008; 50(10):744-50. https://doi.org/10.1111/j.1469-8749.2008.03089.x.
- Hidecker MJC, Paneth N, Rosenbaum PL, et al. Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Dev Med Child Neurol. 2011; 53(8):704-10. https://doi.org/10.1111/j.1469-8749.2011.03996.x.
- Mutlu A, Kara ÖK, Livanelioğlu A, et al. Agreement between parents and clinicians on the communication function levels and relationship of classification systems of children with cerebral palsy. Disabil Health J. 2018; 11(2):281-286. https://doi.org/10.1016/j.dhjo.2017.11.001.
- Compagnone E, Maniglio J, Camposeo S, et al. Functional classifications for cerebral palsy: correlations between the gross motor function classification system (GMFCS), the manual ability classification system (MACS) and the communication function classification system (CFCS). Res Dev Disabi. 2014; 35(11):2651-7. https://doi.org/10.1016/j.ridd.2014.07.005.
- Hidecker MJC, Ho NT, Dodge N, et al. Inter‐relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children. Dev Med Child Neurol. 2012; 54(8):737-42. https://doi.org/doi: 10.1111/j.1469-8749.2012.04312. x.
- Öhrvall AM, Eliasson AC, Löwing K, et al. Self‐care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications. Dev Med Child Neurol. 2010; 52(11):1048-55. https://doi.org/10.1111/j.1469-8749.2010.03764. x.
- Gunel MK, Mutlu A, Tarsuslu T, et al. Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy. Eur J Pediatr. 2009; 168(4):477-85. https://doi.org/10.1007/s00431-008-0775-1.
- Bleyenheuft Y, Gordon AM, Rameckers E, et al. Measuring changes of manual ability with ABILHAND‐Kids following intensive training for children with unilateral cerebral palsy. Dev Med Child Neurol. 2017; 59(5):505-511. https://doi.org/doi: 10.1111/dmcn.13338
- Akpinar P, Tezel CG, Eliasson AC, et al. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabi. 2010; 32(23):1910-6. https://doi.org/10.3109/09638281003763796 Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol. 2000; 42(5):292-6. https://doi.org/10.1017/s0012162200000529.
- Pearse J, Basu AP. ABILHAND-Kids questionnaire: responsive to change or room for change? Dev Med Child Neurol. 2017; 59(5):457. https://doi.org/ 10.1111/dmcn.13378
- Rehab-Scales. ABILHAND-Kids specific to cerebral palsy children. Accesssed at: http://rssandbox.iescagilly.be/~abilhand-kids-cerebral-palsy-en.html
- Şahin E, Dilek B, Karakaş A, et al. Reliability and Validity of the Turkish Version of the ABILHAND-Kids Survey in Children with Cerebral Palsy. Turk J Phys Med Rehabil. 2020; 66(4):444-451. https://doi.org/10.5606/tftrd.2020.4091
- Bedell G, Khetani M, Coster J, et al. Measures of participation in community, social and civic life for children with disabilities. Measures of Outcomes and Their Determinants for Children and Youth with Developmental Disabilities; Majnemer, A., Ed. Mac Keith Press London; 2012
- Atasavun Uysal S, Dülger E, Bilgin S, et al. Investigation of the validity and reliability of the Turkish Child and Adolescent Participation Questionnaire (CASP). Turkish Turk J Physiother Rehabil. 2018; 29: 87. Accessed at: https://dergipark.org.tr/en/download/issue-full-file/38875
- Palisano RJ, Avery L, Gorter JW, et al. Stability of the gross motor function classification system, manual ability classification system, and communication function classification system. Dev Med Child Neurol. 2018; 60(10):1026-1032. https://doi.org/10.1111/dmcn.13903.
- Klingels K, Demeyere I, Jaspers E, et al. Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy. Eur J Paediatr Neurol. 2012; 16(5):475-84. https://doi.org/doi: 10.1016/j.ejpn.2011.12.008.
Konjenital Hemiplejik Serebral Palsili Çocuklarda Üst Ekstremite Fonksiyonlarına ve Katılıma Göre Yüksek-Orta Fonksiyonel Durumun Temsilcileri Arasındaki Farkların İncelenmesi: Kesitsel Bir Çalışma
Abstract
Bu çalışmanın amacı, sınıflandırma sistemleri bağlamında Serebral Palsili (SP) bireylerde el becerisi ve katılım performansı kazanımlarını araştırmaktı. Başka bir anlatımla, SP'li bireylerde fonksiyonel durumun üç temsilcisinin el becerisi ve katılım sonuçlarına göre farklılık gösterip göstermediğini görmek amaçlandı. Çalışmaya SP tanısı konulmuş 71 kişi (ortalama 12.4 SS 2.3 yıl; 38 erkek ve 33 kız) alındı. Çalışma katılımcılarının fonksiyonel durumları El Becerileri Sınıflandırma Sistemi (EBSS), Kaba Motor Fonksiyon Sınıflandırma Sistemi-Genişletilmiş&Düzenlenmiş (KMFSS-G&D) ve İletişim Becerileri Sınıflandırma Sistemi (İFSS) kullanılarak belirlendi. El becerisi ve katılım sonuçları, sırasısyla ABILHAND-Kids anketi ve Çocuk ve Adölesan Katılım Ölçeği (CASP) kullanılarak belgelendi. Post-hoc testleri, yüksek EBSS ve KMFSS-G&D seviyelerine sahip bireylerin, düşük MACS ve GMFCS-E&R seviyelerine sahip kişilere kıyasla ABILHAND-Kids ve CASP'ta daha yüksek puanlar aldıklarını göstermiştir (I>II>III, P<0.0001). Benzer şekilde, İFSS I'deki bireyler hem ABILHAND-Kids hem de CASP' ta İFSS III' tekilere kıyasla daha iyi puan aldılar (I>III, P<0.001). Aksine, İFSS I-II veya İFSS II-III olarak sınıflandırılan bireylerde ABILHAND-Kids ve CASP skorları benzerdi (P>0.05). Son olarak, çoklu regresyon analizleri EBSS ve KMFSS-G&D’nin el becerisini (EBSS: %65; KMFSS-G&D: %23) ve katılım sonuçlarını (EBSS: %46-%62; KMFSS-G&D: %57-%68) güçlü bir şekilde öngördüğünü ortaya koydu. EBSS ve KMFSS-G&D’den elde edilen bilgiler, SP'li bireylerde el becerisi ve katılım sonuçları hakkında fikir verebilir
Keywords
Ethical Statement
The study protocol was approved by the Ethical Board at Muş Alparslan University (approval number: 26.11.2021-30767).
Supporting Institution
Yok
Thanks
The authors would like to thank the participating children and their families/legal guardians for their generous support in carrying out the study.
References
- McConnell K, Johnston L, Kerr C. Upper limb function and deformity in cerebral palsy: a review of classification systems. Dev Med Child Neurol. 53(9):799-805. https://doi.org/ 10.1111/j.1469-8749.2011.03953. x.
- Gilmore R, Sakzewski L, Boyd R. Upper limb activity measures for 5‐to 16‐year‐old children with congenital hemiplegia: a systematic review. Dev Med Child Neurol. 52(1):14-21. https://doi.org/10.1111/j.1469-8749.2009.03369. x. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol Suppl. 2007; 49(6):480. PMID: 17370477.
- Eliasson AC, Krumlinde-Sundholm L, Rösblad B, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006; 48(7):549-54. https://doi.org/10.1017/S0012162206001162
- Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy. Children. 2017; 24;4(4):30. https://doi.org/10.3390/children4040030
- Öhrvall AM, Krumlinde-Sundholm L, Eliasson AC. Exploration of the relationship between the Manual Ability Classification System and hand-function measures of capacity and performance. Disabil Rehabi. 2013; 35(11):913-8. https://doi.org/10.3109/09638288.2012.714051
- Palisano RJ, Rosenbaum P, Bartlett D, et al. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008; 50(10):744-50. https://doi.org/10.1111/j.1469-8749.2008.03089.x.
- Hidecker MJC, Paneth N, Rosenbaum PL, et al. Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Dev Med Child Neurol. 2011; 53(8):704-10. https://doi.org/10.1111/j.1469-8749.2011.03996.x.
- Mutlu A, Kara ÖK, Livanelioğlu A, et al. Agreement between parents and clinicians on the communication function levels and relationship of classification systems of children with cerebral palsy. Disabil Health J. 2018; 11(2):281-286. https://doi.org/10.1016/j.dhjo.2017.11.001.
- Compagnone E, Maniglio J, Camposeo S, et al. Functional classifications for cerebral palsy: correlations between the gross motor function classification system (GMFCS), the manual ability classification system (MACS) and the communication function classification system (CFCS). Res Dev Disabi. 2014; 35(11):2651-7. https://doi.org/10.1016/j.ridd.2014.07.005.
- Hidecker MJC, Ho NT, Dodge N, et al. Inter‐relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children. Dev Med Child Neurol. 2012; 54(8):737-42. https://doi.org/doi: 10.1111/j.1469-8749.2012.04312. x.
- Öhrvall AM, Eliasson AC, Löwing K, et al. Self‐care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications. Dev Med Child Neurol. 2010; 52(11):1048-55. https://doi.org/10.1111/j.1469-8749.2010.03764. x.
- Gunel MK, Mutlu A, Tarsuslu T, et al. Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy. Eur J Pediatr. 2009; 168(4):477-85. https://doi.org/10.1007/s00431-008-0775-1.
- Bleyenheuft Y, Gordon AM, Rameckers E, et al. Measuring changes of manual ability with ABILHAND‐Kids following intensive training for children with unilateral cerebral palsy. Dev Med Child Neurol. 2017; 59(5):505-511. https://doi.org/doi: 10.1111/dmcn.13338
- Akpinar P, Tezel CG, Eliasson AC, et al. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabi. 2010; 32(23):1910-6. https://doi.org/10.3109/09638281003763796 Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol. 2000; 42(5):292-6. https://doi.org/10.1017/s0012162200000529.
- Pearse J, Basu AP. ABILHAND-Kids questionnaire: responsive to change or room for change? Dev Med Child Neurol. 2017; 59(5):457. https://doi.org/ 10.1111/dmcn.13378
- Rehab-Scales. ABILHAND-Kids specific to cerebral palsy children. Accesssed at: http://rssandbox.iescagilly.be/~abilhand-kids-cerebral-palsy-en.html
- Şahin E, Dilek B, Karakaş A, et al. Reliability and Validity of the Turkish Version of the ABILHAND-Kids Survey in Children with Cerebral Palsy. Turk J Phys Med Rehabil. 2020; 66(4):444-451. https://doi.org/10.5606/tftrd.2020.4091
- Bedell G, Khetani M, Coster J, et al. Measures of participation in community, social and civic life for children with disabilities. Measures of Outcomes and Their Determinants for Children and Youth with Developmental Disabilities; Majnemer, A., Ed. Mac Keith Press London; 2012
- Atasavun Uysal S, Dülger E, Bilgin S, et al. Investigation of the validity and reliability of the Turkish Child and Adolescent Participation Questionnaire (CASP). Turkish Turk J Physiother Rehabil. 2018; 29: 87. Accessed at: https://dergipark.org.tr/en/download/issue-full-file/38875
- Palisano RJ, Avery L, Gorter JW, et al. Stability of the gross motor function classification system, manual ability classification system, and communication function classification system. Dev Med Child Neurol. 2018; 60(10):1026-1032. https://doi.org/10.1111/dmcn.13903.
- Klingels K, Demeyere I, Jaspers E, et al. Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy. Eur J Paediatr Neurol. 2012; 16(5):475-84. https://doi.org/doi: 10.1016/j.ejpn.2011.12.008.
Details
| Primary Language | English |
|---|---|
| Subjects | Physiotherapy |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Early Pub Date | April 28, 2024 |
| Publication Date | April 30, 2024 |
| Submission Date | December 26, 2023 |
| Acceptance Date | February 3, 2024 |
| Published in Issue | Year 2024 Volume: 5 Issue: 1 |
