Gross motor function in cerebral palsy: the association with age, motor type and topographical distribution

Adebimpe O Obembe; Olubusola E Johnson; Morenike C Ola

doi:10.34058/njmr.v16i2.79

Adebimpe O Obembe Obafemi Awolowo University, Ile-Ife
Olubusola E Johnson Obafemi Awolowo University, Ile-Ife
Morenike C Ola Obafemi Awolowo University

DOI: https://doi.org/10.34058/njmr.v16i2.79

Keywords: physiotherapy, rehabilitation, cerebral palsy, children, motor function, disability

Abstract

Background: Cerebral palsy is a major cause of disability in children and information about factors influencing prognosis of gross motor function is necessary to establish realistic physiotherapy treatment goals.

Objectives: To determine the association of gross motor function of children with cerebral palsy with age, motor type, topographical distribution.

Methods: This is a cross-sectional study of children with cerebral seen at the outpatient physiotherapy departments of selected hospitals and at the special schools for children with special needs in Osun, Nigeria. Gross motor function ability was categorized using the Gross Motor Function Classification System (GMFCS).

Results: A total of 154 children (96 males and 58 females) aged 9 months 12 years (mean 5.62 4.28 years) were recruited in this study. Twenty participants (13%) had severe deficits (GMFCS level V), 54 (35.1%) had moderate deficits (GMFCS level III) while 8 participants (5.2%) had mild deficits (GMFCS level I). Based on topographical distributions and motor type, many of the participants had quadriplegia (67.5%) and spastic subtype (71.4%) respectively. There was a significant difference in the gross motor function ability among the different age groups. Gross motor function ability had significant associations with age (?= .620, p = .004), motor type (?=.484, p =.031) and topographical distribution (?=.239, p=.020).

Conclusion: This study concluded that age, motor type and topographical distribution are factors associated with gross motor function of children with cerebral palsy. This may have implications in guiding prognosis, improving the strategies of physiotherapy interventions and counseling families of these children.

Author Biographies

Adebimpe O Obembe, Obafemi Awolowo University, Ile-Ife

Dept of Medical Rehabilitation, Senior lecturer

Olubusola E Johnson, Obafemi Awolowo University, Ile-Ife

Dept of Medical Rehabilitation, Senior lecturer

Morenike C Ola, Obafemi Awolowo University

Dept of Medical Rehabilitation

References

Bax, M., Goldstein, M., Rosenbaum, P., Leviton A, Paneth M. Dan, B., Jacobsson, B., Damiano, D. (2005). Proposed definition and classification of cerebral palsy. Dev Med Child Neurol, 47, 571-576.

Beckung, E., Carlsson, G., Carlsdotter, S., Uvebrant, P., 2007. The natural history of gross mo-tor development in children with cerebral palsy aged 1 to 15 years. Dev Med Child Neurol, 49,751-756.

Belonwu, R.O., Gwarzo, G.D., Adeleke, S.I., 2009. Cerebral palsy in Kano, Nigeria--a review. Niger J Med, 18,186.

Caram, L.H.A., Funayama, C.A.R., Spina, C.I., Giuliani, L.R., Pina Neto, J.M, 2006. In-vestigation of neurodevelopment delay etiology: resources and challenges. Arq Neuropsiquiatr,64, 466-472.

Carnahan, K.D., Arner, M., Hgglund, G., 2007. Association between gross motor function (GMFCS) and manual ability (MACS) in children with cerebral palsy. A population-based study of 359 children. BMC Musculoskeletal Disorders, 8,50.

Eseigbe, E.E., Anyiam, J.O., Wammanda, R.D., Obajuluwa, S.O., Rotibi, B.B., Simire-Abraham, M.K., 2012. A Comparative Assessment of Motor Function using the Expanded and Revised Gross Motor Function Classification System and the Manual Ability Classification System in the same Children with Cerebral Palsy in Shika, Zaria, Northwestern Nigeria. West Afr J Med, 31(4), 219-23.

Gorter, J.W., Rosenbaum, P.L., Hanna, S.E., Palisano, R.J., Bartlett, D.J., Russell, D.J., Walter, S.D., Raina, P., Galuppi, B.E., Wood, E., 2004. Limb Distribution, Type of Motor Disorder and Functional Classification of Cerebral Palsy How do They Relate? Dev Med Child Neurol, 46, 461-467.

Gorter, J.W., Ketelaar, M., Rosenbaum, P., Helders, P.J.M., Palisano, R., 2009. Use of the GMFCS in infants with CP: the need for reclassification at age 2 years or older. Dev Med Child Neurol, 51, 46-52.

Hamzat, T.K., Fatudimu, M.B., 2008. Caregivers or care providers: Who should assess motor function in cerebral palsy? J Pediatr Neurol, 6(4), 345-350.

Himmelmann, K., Beckung, E., Hagberg, G., Uvebrant, P., 2006. Gross and fine motor function and accompanying impairments in cerebral palsy. Dev Med Child Neurol, 48, 417-423.

Howard, J., Soo, B., Graham, H.K., Boyd, R.N., Reid S., Lanigan, A., Wolfe, R., Reddihoug, D.S., 2005. Cerebral palsy in Victoria: Motor types, topography and gross motor function. J. Paediatr. Child Health, 41, 479483.

Johnston, M.V., Hagberg, H., 2007. Sex and the pathogenesis of cerebral palsy. Dev Med Child Neurol, 49(1), 74-8.

Krigger, K.W., 2006. Cerebral palsy: an overview. Am Fam Physician, 73 ,91100.

Lagunju, I.A., Adedokun, B.O., Fatunde, O.J., 2006. Risk factors for epilepsy in children with cerebral palsy. African Journal of Neurological Sciences, 25 (2), 29-37.

Melisa, S.Y., Chee, P.W., 2002. Impact of cerebral palsy on the quality of life in patients and their families. Neurology, 14, 27-33.

Morris, C., Bartlett, D., 2004. Gross Motor Function Classification System: impact and utility. Developmental Medicine & Child Neurology, 46, 6065.

Morris, C., Galuppi, B.E., Rosenbaum, P.L., 2004. Reliability of family report for the Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 46, 455460.

Mutch, L., Alberman, E., Hagberg, B., Kodama, K., Perat, M.V., 1992. Cerebral palsy Epidemi-ology: Where are we now and where are we going? Dev. Med Child Neurol, 34, 547-551.

Nordmark, E., Hgglund, G., Lagergren, J., 2001. Cerebral palsy in southern Sweden II. Gross motor function and disabilities. Acta Paediatrica, 90 (11), 1277 1282.

Nottidge, V.A., Okogbo, M.E., 1991. Cerebral Palsy in Ibadan, Nigeria. Developmental Medicine and Child Neurology, 33 ,241-45.

Ogunlesi, T., Ogundeyi, M., Adekanmbi, F., Fetuga, B., Ogunfowora, O., Olowu, A., 2008. Socio-clinical issues in cerebral palsy in Sagamu, Nigeria. South African Journal of Child Health, 2 (3), 120-4.

Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., Galuppi, B., 1997. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol, 39, 214223.

Pfeifer, L.I., Silva, D.B.R., Funayama, C.A.R., Santos, J.L., 2009. Classification of Cerebral Palsy Association between gender, age, motor type, topography and Gross Motor Function. Neuropsiquiatr, 67(4), 1057-1061.

Rosenbaum, P.L., Walter, S.D., Hanna, S.E., Palisano, R.J., Russell, D.J., Raina, P., Wood, E., Bartlett, D.J., Galuppi, B.E., 2002. Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA, 288(11), 1357-1363.

Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., 2007. The Definition and Classification of Cerebral Palsy April 2006. Developmental Medicine and Child Neurology Journal Supplement, 49, 8-14.

Sathiakumar, N., Yakubu, A.M., 1987. Cerebral palsy in Zaria, northern Nigeria. Is it preventable? J Trop Paediatr, 33, 40 42.

Shevell, M.I., Dagenais, L., Hall, N., 2009. The relationship of cerebral palsy subtype and func-tional motor impairment: a population-based study. Developmental Medicine & Child Neurolo-gy, 51, 872877.

Sigurdardttir, S., Thrkelsson, T., Halldrsdttir, M., Thorarensen, . and Vik, T. 2009. Trends in prevalence and characteristics of cerebral palsy among Icelandic children born 1990 to 2003. Developmental Medicine & Child Neurology, 51, 356363.

Tella, B.A., Gbiri, C.A., Osho, O.A., Ogunrinu, A.E., 2011. Health related quality of life of Ni-geria children with cerebral palsy. Disabil CBR Inclusive Dev, 22 (1), 95104.

Tieman, B.L., Palisano, R.J., Gracely, E.J., Rosenbaum, P.L., 2004. Gross motor capability and performance of mobility in children with cerebral palsy: a comparison across home, school, and outdoors/community settings. Phys Ther, 84(5), 419-29.

Voorman, J.M., Dallmeijer, A.J., Knol, D.L., Lankhorst, G.J., Becher, J.G., 2007. Prospective longitudinal study of gross motor function in children with cerebral palsy. Arch Phys Med Rehabil, 88, 871-876.