Low Functioning Cerebral Palsy Physiotherapy Assessment and Intervention: Difference between revisions
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**least common form of cerebral palsy | **least common form of cerebral palsy | ||
**children present with incoordination of goal-directed movements | **children present with incoordination of goal-directed movements | ||
The distribution of cerebral palsy can be unilateral or bilateral. | |||
For more information on the types of cerebral palsy, please see: [[Cerebral Palsy Aetiology and Pathology]]. | |||
== Gross Motor Function Classification System (GMFCS) == | |||
The Gross Motor Function Classification System (GMFCS) is a valid and reliable system that classifies children with cerebral palsy aged 2-18 years based on their gross motor function.<ref>Patel DR, Neelakantan M, Pandher K, Merrick J. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082248/ Cerebral palsy in children: a clinical overview]. Transl Pediatr. 2020 Feb;9(Suppl 1):S125-S135.</ref> | |||
It is a 5-point ordinal scale<ref>Ko J, Woo J, Her JG. [https://www.jstage.jst.go.jp/article/jpts/23/2/23_2_255/_pdf The reliability and concurrent validity of the GMFCS for children with cerebral palsy]. Journal of Physical Therapy Science. 2011;23: 255-8. </ref> that describes a child’s self-initiated movements and use of assistive devices for mobility.<ref name=":1">Paulson A, Vargus-Adams J. [https://www.mdpi.com/2227-9067/4/4/30 Overview of four functional classification systems commonly used in cerebral palsy]. Children (Basel). 2017 Apr 24;4(4):30. </ref> | |||
The levels are as follows:<ref name=":1" /><ref>CanChild. Gross Motor Function Classification System - Expanded & Revised. Available from: https://canchild.ca/en/resources/42-gross-motor-function-classification-system-expanded-revised-gmfcs-e-r (last accessed 27 September 2023).</ref> | |||
* Level I: able to walk without limitations | |||
* Level II: can walk with limitations (e.g. balance, endurance limitations) | |||
* Level III: can walk using a hand-held mobility device (may use additional support, such as wheeled mobility, for longer distances, outdoors) | |||
* Level IV: self-mobility is limited - may be transported in a manual wheelchair or may use powered mobility | |||
* Level V: transported in a manual wheelchair | |||
Reid et al.<ref>Reid SM, Carlin JB, Reddihough DS. [https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-8749.2011.04044.x Using the Gross Motor Function Classification System to describe patterns of motor severity in cerebral palsy]. Developmental Medicine & Child Neurology, 2011 Nov 1;53(11):1007-12. </ref> note that a child classified as Level I will be able to perform the same activities as their peers, but their speed, balance or coordination may be impacted. However, a child classified as Level V will have difficulty achieving voluntary control of movement, and their head/trunk control is affected in many positions. | |||
== References == | == References == | ||
Revision as of 03:15, 8 November 2023
Original Editor - Jess Bell based on the course by Dana Mather
Top Contributors - Jess Bell and Kim Jackson
Top Contributors - Jess Bell and Kim Jackson
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (8/11/2023)
Introduction[edit | edit source]
Cerebral palsy (CP) is a heterogeneous non-progressive neuromotor disorder in an immature brain that affects movement and posture.[1] Primary impairments associated with cerebral palsy include spasticity, weakness, decreased motor control and movement dysfunction.[2] Cerebral palsy can also lead to a number of secondary musculoskeletal conditions, which can also affect functional ability.[2]
Children with cerebral palsy all present differently. Their mobility varies from walking without aids to using a wheelchair at all times.[3] There are various diagnostic sub-types, based on motor type and the distribution of cerebral palsy.
Types of cerebral palsy:[3] [4]
- Spastic cerebral palsy
- most common type and most amenable to treatment[5]
- there are five types of spastic cerebral palsy:[3]
- diplegia - either both arms or both legs are affected (most commonly both legs are affected)
- hemiplegia or hemiparesis - affects the limbs on only one side of the body
- quadriplegia or quadriparesis - all four limbs are affected
- monoplegia - only one limb is affected (extremely rare)
- triplegia - three limbs are affected
- Dyskinetic cerebral palsy[6][7]
- involves injury to the basal ganglia
- children have impaired movement control, muscle tone and coordination
- Ataxic cerebral palsy[8][9]
- least common form of cerebral palsy
- children present with incoordination of goal-directed movements
The distribution of cerebral palsy can be unilateral or bilateral.
For more information on the types of cerebral palsy, please see: Cerebral Palsy Aetiology and Pathology.
Gross Motor Function Classification System (GMFCS)[edit | edit source]
The Gross Motor Function Classification System (GMFCS) is a valid and reliable system that classifies children with cerebral palsy aged 2-18 years based on their gross motor function.[10]
It is a 5-point ordinal scale[11] that describes a child’s self-initiated movements and use of assistive devices for mobility.[3]
The levels are as follows:[3][12]
- Level I: able to walk without limitations
- Level II: can walk with limitations (e.g. balance, endurance limitations)
- Level III: can walk using a hand-held mobility device (may use additional support, such as wheeled mobility, for longer distances, outdoors)
- Level IV: self-mobility is limited - may be transported in a manual wheelchair or may use powered mobility
- Level V: transported in a manual wheelchair
Reid et al.[13] note that a child classified as Level I will be able to perform the same activities as their peers, but their speed, balance or coordination may be impacted. However, a child classified as Level V will have difficulty achieving voluntary control of movement, and their head/trunk control is affected in many positions.
References[edit | edit source]
- ↑ Peterson N, Walton R. Ambulant cerebral palsy. Orthopaedics and Trauma. 2016;30(6):525-38.
- ↑ 2.0 2.1 Sarathy K, Doshi C, Aroojis A. Clinical examination of children with cerebral palsy. Indian J Orthop. 2019 Jan-Feb;53(1):35-44.
- ↑ 3.0 3.1 3.2 3.3 3.4 Mather D. Low Functioning Cerebral Palsy Physiotherapy Assessment and Intervention Course. Plus, 2023. Cite error: Invalid
<ref>tag; name ":1" defined multiple times with different content - ↑ Paul S, Nahar A, Bhagawati M, Kunwar AJ. A review on recent advances of cerebral palsy. Oxidative Medicine and Cellular Longevity. 2022 Jul 30;2022.
- ↑ Papavasiliou A, Ben-Pazi H, Mastroyianni S, Ortibus E. Cerebral palsy: new developments. Frontiers in Neurology. 2021;12.
- ↑ Eskay K. Cerebral Palsy Aetiology and Pathology Course. Plus, 2023.
- ↑ Li X, Arya K. Athetoid Cerebral Palsy. InStatPearls [Internet] 2021 Sep 28. StatPearls Publishing.
- ↑ Levy JP, Oskoui M, Ng P, Andersen J, Buckley D, Fehlings D, et al. Ataxic-hypotonic cerebral palsy in a cerebral palsy registry: Insights into a distinct subtype. Neurology: Clinical Practice. 2020 Apr 1;10(2):131-9.
- ↑ Eggink HE, Kremer DA, Brouwer OF, Contarino MF, van Egmond ME, Elema AG, et al. Spasticity, dyskinesia and ataxia in cerebral palsy: are we sure we can differentiate them?. European Journal of Paediatric Neurology. 2017 Sep 1;21(5):703-6.
- ↑ Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr. 2020 Feb;9(Suppl 1):S125-S135.
- ↑ Ko J, Woo J, Her JG. The reliability and concurrent validity of the GMFCS for children with cerebral palsy. Journal of Physical Therapy Science. 2011;23: 255-8.
- ↑ CanChild. Gross Motor Function Classification System - Expanded & Revised. Available from: https://canchild.ca/en/resources/42-gross-motor-function-classification-system-expanded-revised-gmfcs-e-r (last accessed 27 September 2023).
- ↑ Reid SM, Carlin JB, Reddihough DS. Using the Gross Motor Function Classification System to describe patterns of motor severity in cerebral palsy. Developmental Medicine & Child Neurology, 2011 Nov 1;53(11):1007-12.
