Medicine and Health Sciences Commons^™

Remote Ischaemic Conditioning Combined With Bimanual Task Training To Enhance Bimanual Skill Learning And Corticospinal Excitability In Children With Unilateral Cerebral Palsy: A Study Protocol Of A Single Centre, Phase Ii Randomised Controlled Trial, Swati M Surkar, John D Willson, Jessica M Cassidy, Shailesh Kantak, Charity G Patterson

Department of Rehabilitation Medicine Faculty Papers

INTRODUCTION: Children with unilateral cerebral palsy (UCP) have difficulty in bimanual coordination that restricts the child's independence in daily activities. Although several efficacious interventions to improve bimanual coordination exist, these interventions often require higher training doses and have modest effect sizes. Thus, there is a critical need to find an effective priming agent that, when paired with task-specific training, will facilitate neurobiological processes to enhance the magnitude of training effects and subsequently improve functional capabilities of children with UCP. The aim of this study is to determine the effects of a novel priming agent, remote ischaemic conditioning (RIC), combined with …

The Decline Of Physical Activity With Age In School-Aged Children With Cerebral Palsy: A Single-Center Cross-Sectional Observational Study, Jinuk Lee, Min-Hwa Suk, Soojin Yoo, Jeong-Yi Kwon

Health & Human Performance Faculty Publications and Presentations

Maintaining physical activity is important for children with cerebral palsy (CP). This study examined whether age predicted habitual physical activity (HPA) or cardiorespiratory fitness (CRF) in school-aged children with CP and clarified the relationship between HPA and CRF. We utilized cross-sectional data from 39 children with CP (18 girls and 21 boys; mean age 7.44 years; mean body weight 24.76 kg; mean body mass index 15.97 kg/m2; hemiplegic or diplegic CP). The participants wore an accelerometer (ActiGraph) for five days to measure HPA, physical activity energy expenditure (kcal/kg/d), sedentary physical activity (%SPA), light physical activity, moderate-to-vigorous physical activity (%MVPA), and …

Lifelong Fitness In Ambulatory Children And Adolescents With Cerebral Palsy Ii: Influencing The Trajectory, Susan V. Duff, Justine D. Kimbel, Marybeth Grant-Beuttler, Theresa Sukal-Moulton, Noelle G. Moreau, Kathleen M. Friel

Physical Therapy Faculty Articles and Research

Physical activity of at least moderate intensity in all children contributes to higher levels of physical and psychological health. While essential, children with cerebral palsy (CP) often lack the physical capacity, resources, and knowledge to engage in physical activity at a sufficient intensity to optimize health and well-being. Low levels of physical activity place them at risk for declining fitness and health, contributing to a sedentary lifestyle. From this perspective, we describe a framework to foster a lifelong trajectory of fitness in ambulatory children with CP (GMFCS I–III) as they progress into adolescence and adulthood, implemented in conjunction with a …

Lifelong Fitness In Ambulatory Children And Adolescents With Cerebral Palsy Ii: Influencing The Trajectory, Susan V. Duff, Justine D. Kimbel, Marybeth Grant-Beuttler, Theresa Sukal-Moulton, Noelle G. Moreau, Kathleen M. Friel

School of Allied Health Professions Faculty Publications

Physical activity of at least moderate intensity in all children contributes to higher levels of physical and psychological health. While essential, children with cerebral palsy (CP) often lack the physical capacity, resources, and knowledge to engage in physical activity at a sufficient intensity to optimize health and well-being. Low levels of physical activity place them at risk for declining fitness and health, contributing to a sedentary lifestyle. From this perspective, we describe a framework to foster a lifelong trajectory of fitness in ambulatory children with CP (GMFCS I–III) as they progress into adolescence and adulthood, implemented in conjunction with a …

Improvements In Lower Limb Spasticity-Related Pain In Children/Adolescents With Cerebral Palsy After Incobotulinumtoxina Injections, Florian Heinen, Michaela Bonfert, Petr Kanovsky, A Sebastian Schroeder, Henry Chambers, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

Conference Presentation Abstracts

Introduction: The effects of incobotulinumtoxinA on lower limb (LL) spasticity-related pain (SRP) over multiple treatment cycles (ICs) in children/adolescents (C/As) with cerebral palsy (CP) were analyzed using pooled data from three prospective phase 3 trials.

Patients and methods: C/As aged 2–17 years with CP-associated LL spasticity received incobotulinumtoxinA for 4 ICs. SRP was assessed with the Questionnaire on Pain caused by Spasticity (QPS) using C/A- (direct or via interviewer) and parent/caregiver (P/C)-completed LL modules. The pain population included all C/As with a key QPS item score >0 at baseline; post-baseline scores of 0 indicated complete pain relief.

Results: Data from …

Improvements In Upper Limb Spasticity-Related Pain In Children/Adolescents With Cerebral Palsy After Incobotulinumtoxina Injections, Florian Heinen, Michaela Bonfert, Petr Kanovsky, A Sebastian Schroeder, Henry Chambers, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

Conference Presentation Abstracts

Introduction: The effects of incobotulinumtoxinA on upper limb (UL) spasticity-related pain (SRP) over multiple treatment cycles (ICs) in children/adolescents (C/As) with cerebral palsy (CP) were analyzed using pooled data from two prospective phase 3 trials.

Patients and methods: C/As aged 2–17 years with CP-associated UL spasticity received incobotulinumtoxinA for 4 ICs. SRP was assessed with the Questionnaire on Pain caused by Spasticity (QPS) using C/A- (direct or via interviewer) and parent/caregiver (P/C)-completed UL modules. The pain population included all C/As with a key QPS item score >0 at baseline; post-baseline scores of 0 indicated complete pain relief.

Results: Data from …

Prevalence Of Spasticity-Related Pain In Children/Adolescents With Cerebral Palsy, Florian Heinen, Michaela Bonfert, Petr Kanovsky, A Sebastian Schroeder, Henry Chambers, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

Conference Presentation Abstracts

Introduction: This analysis determined the prevalence and intensity of spasticity-related pain (SRP) in children/adolescents (C/As) with cerebral palsy (CP).

Patients and methods: Baseline data from the prospective incobotulinumtoxinA trials TIM, TIMO and XARA were pooled. In all three studies, SRP was assessed in C/As aged 2–17 years with lower limb (LL) and/or upper limb (UL) spasticity using the Questionnaire on Pain caused by Spasticity (QPS); both self-reports (direct or via interviewer) and parent/caregiver (P/C) observer reports were included. A C/A was considered to have SRP if any QPS key item score was rated >0 at baseline. Individual QPS modules were …

Absence Of Neutralizing Antibody Formation During Incobotulinumtoxina Treatement Of Spasticity In Botulinum Toxin-Naive Children With Cerebral Palsy: Pooled Analysis Of Three Phase 3 Studies, Henry Chambers, Petr Kanovsky, A Sebastian Schroeder, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spira, Florian Heinen

Conference Presentation Abstracts

Introduction: The development of neutralizing antibodies (NAbs) has been linked to secondary non-response to botulinum neurotoxin type A (BoNT-A) injections. This may be of special concern when treating conditions like pediatric spasticity. We investigated NAb formation in three large Phase 3 studies with incobotulinumtoxinA, a BoNT-A lacking complexing proteins, in children/adolescents with cerebral palsy (CP).

Patients and methods: Patients with lower-limb (LL), upper-limb (UL), or combined LL/UL spasticity (2–17 years; uni- or bilateral CP; Ashworth Scale score ≥2 in clinical patterns for treatment) received total body weight incobotulinumtoxinA ≤16–20 U/kg (max. 400–500 U) depending on the study (TIM: NCT01893411; TIMO: …

Safety Of Incobotulinumtoxina In Multipattern Treatment Of Upper And Lower Limb Spasticity In Children/Adolescents With Cerebral Palsy: Pooled Analysis Of 3 Large Phase 3 Studies, Marta Banach, Petr Kanovsky, A Sebastian Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Michael Althaus, Deborah Gaebler-Spriag, Florian Heinen

Conference Presentation Abstracts

Introduction: This analysis assessed the safety and tolerability of repeated incobotulinumtoxinA treatment for lower-limb (LL), upper-limb (UL), or combined LL/UL spasticity in ambulant and non-ambulant children/adolescents with cerebral palsy (CP) using pooled data from 3 large Phase 3 studies.

Methods: Pediatric patients with spasticity (2–17 years of age; uni- or bilateral CP; Gross Motor Function Classification System [GMFCS] level I-V; Ashworth Scale [AS] score ≥2 in clinical patterns for treatment; clinical need for treatment) were enrolled. Patients received total body incobotulinumtoxinA doses of 16 U/kg body weight (BW, ≤400 U) for LL spasticity in 2 injection cycles (ICs) in TIM …

Improvement Of Spasticity-Related Pain With Incobotulinumtoxina Treatment In Children/Adolescents With Cerebral Palsy: Pooled Analysis Of 3 Phase 3 Studies, Florian Heinen, Petr Kanovsky, A Sebastian Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spirag

Conference Presentation Abstracts

Introduction: Spasticity-related pain (SRP) in children and adolescents with cerebral palsy (CP) is common, often neglected, and impacts daily quality of life. We assessed the effect of incobotulinumtoxinA on SRP using pooled data from 3 large Phase 3 pediatric studies.

Methods: Ambulant and non-ambulant patients (2–17 years of age; uni- or bilateral CP; Ashworth Scale score ≥2 in clinical patterns for treatment) were enrolled. Patients received total body incobotulinumtoxinA doses of ≤16 U/kg (≤400 U) for lower-limb (LL) treatment in 2 injection cycles (ICs) in TIM (NCT01893411). In TIMO (NCT01905683), TIM completers and new recruits received 4 ICs with 16–20 …

Pooled Efficacy Analysis Of Incobotulinumtoxina In The Multipattern Treatment Of Upper- And Lower-Limb Spasticity In Children And Adolescents With Cerebral Palsy, Florian Heinen, Petr Kanovsky, A Sebastitan Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spirag

Conference Presentation Abstracts

Introduction: This pooled analysis assessed the efficacy of incobotulinumtoxinA for lower-limb (LL) and upper-limb (UL) spasticity in children and adolescents with cerebral palsy (CP) using data from the first controlled injection cycle of 2 large Phase 3 studies, TIM (NCT01893411) and XARA (NCT02002884).

Methods: Ambulant and non-ambulant pediatric patients with spasticity due to CP (2–17 years of age; uni- or bilateral CP; Ashworth Scale [AS] score ≥2 in clinical patterns for treatment) were enrolled. Patients were randomized (2:1:1) to 3 incobotulinumtoxinA dose groups: 8, 6, 2 U/kg body weight (BW), maximum 200, 150, 50 U per LL clinical pattern in …

The Association Between Motor Capacity And Motor Performance In School-Aged Children With Cerebral Palsy: An Observational Study, Min-Hwa Suk, In-Kyeong Park, Soojin Yoo, Jeong-Yi Kwon

Health & Human Performance Faculty Publications and Presentations

Background

This study aimed to investigate the association between motor capacity and motor performance in children with cerebral palsy (CP) aged 6–12 years with Gross Motor Function Classification System (GMFCS) levels I to III.

Methods

Forty-six children with CP (24 boys and 22 girls) classified as GMFCS levels Ⅰ, Ⅱ, or Ⅲ were included. Motor capacity was measured by the Gross motor function measure (GMFM), Pediatric balance scale (PBS), Timed up and go (TUG), and 6-min walk test (6MWT). Motor performance was measured by triaxial accelerometers. Estimations of physical activity energy expenditure (PAEE) (kcal/kg/day), percentage of time spent on …

Neurophysiological Assessments Of Brain And Spinal Cord Associated With Lower Limb Functions In Children With Cerebral Palsy: A Protocol For Systematic Review And Meta-Analysis, Leonard Ubalde, Jing Nong Liang

Physical Therapy Faculty Publications

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to …

Effects Of Speech Cues In French-Speaking Children With Dysarthria, Erika S. Levy, Gemma Moya-Galé, Younghwa Michelle Chang, Luca Campanelli, Andrea A. N. Macleod, Sergio Escorial, Christelle Maillart

Publications and Research

Background: Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children’s intelligibility deficits and negatively affecting their social participation. However, the effects of speech-treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English-speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in …

Cardiorespiratory Fitness, Balance And Walking Improvements In An Adolescent With Cerebral Palsy (Gmfcs Ii) And Autism After Motor-Assisted Elliptical Training, Guilherme Manna Cesar, Thad W. Buster, Judith M. Burnfield

Department of Mechanical and Materials Engineering: Faculty Publications

Purpose: To quantify the impact of motor-assisted elliptical (ICARE) training on cardiorespiratory fitness, balance and walking function of an adolescent with walking limitations due to cerebral palsy.

Materials and methods: A thirteen-year-old boy with hemiplegic cerebral palsy (Gross Motor Function Classification System II) and autism participated. Peak oxygen consumption (peak VO₂, primary outcome measure), oxygen cost of walking, Pediatric Balance Scale (PBS), modified Timed Up and Go (mTUG), 2-Minute Walk Test (2MWT), and gait characteristics (speed, cadence, step length, single support time) were assessed prior to and after completion of 24 sessions of moderate- to vigorous- intensity ICARE …

Longitudinal Change In Common Impairments In Children With Cerebral Palsy From Age 1.5 To 11 Years, Lynn M Jeffries, Alyssa Laforme Fiss, Sarah Westcott Mccoy, Lisa Avery

Physical Therapy Publications

Purpose: This project aimed to determine if change occurs over time for impairments of balance, range of motion (ROM), endurance, and strength of children with cerebral palsy (CP), by Gross Motor Function Classification System (GMFCS) levels.

Methods: Measurements were completed in 77 children at two sessions (T1, T2) on average 5.8 years apart. Mean ages were 2.9 years (SD .9) and 8.7 years (SD 1.1) at T1 and T2, respectively.

Results: Significant differences were noted from T1 to T2 for some children (GMFCS levels I, II, and III/IV: balance increased, GMFCS levels I and II: strength increased, and GMFCS levels …

Physical, Occupational, And Speech Therapy For Children With Cerebral Palsy., Sarah Westcott Mccoy, Robert Palisano, Lisa Avery, Lynn Jeffries, Alyssa Laforme Fiss, Lisa Chiarello, Steve Hanna

Physical Therapy Publications

AIM: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).

METHOD: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal …

Self-Care Trajectories And Reference Percentiles For Children With Cerebral Palsy., Robert J Palisano, Lisa A Chiarello, Lisa Avery, Steven Hanna, On Track Study Team

Physical Therapy Publications

Aims: To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP).

Methods: Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) levels were determined by consensus between parents and therapists. Parents' completed the Performance in Self-Care domain of the Child Engagement in Daily Life Measure two to five times at 6-month intervals. Nonlinear mixed-effects models were used to create longitudinal trajectories. Quantile regression was used to construct cross-sectional reference percentiles. …

Longitudinal Changes In Physical Caregiving For Parents Of Children With Cerebral Palsy., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy, Margo Orlin, Ehab M Abd-Elkafy

Physical Therapy Publications

Aims: To determine changes in physical caregiving for parents of children with cerebral palsy (CP) over a two-year period based on children’s gross motor function level and age.

Methods: 153 parents of children with CP rated their physical caregiving using the Ease of Caregiving for Children three times over two years. Parents and assessors classified children’s gross motor function using the Gross Motor Function Classification System (GMFCS). Physical caregiving was compared at three test times among parents of children grouped by GMFCS level (I, II–III, and IV–V) and age (1.7–5.9 and 6–11 years) using a three-way mixed ANOVA.

Results: Among …

Ease Of Caregiving For Children: Re-Validation Of Psychometric Properties Of The Measure For Children With Cerebral Palsy Up To 11 Years Of Age., Mohammed S Alghamdi, Lisa A Chiarello, Lisa Avery, Robert J Palisano

Physical Therapy Publications

PURPOSE: To re-validate stability and hierarchal ordering of items, test-retest reliability, and construct validity of the Ease of Caregiving for Children measure for parents of children with cerebral palsy (CP) up to 11 years of age.

METHODS: Participants were 613 parents of children with CP between 1.5 and 11 years of age. Parents completed Ease of Caregiving for Children and both parents and therapists classified children's levels of gross motor, manual and communication functions.

RESULTS: Rasch analysis indicated acceptable fit of items, stable item calibration, and logical ordering of items by difficulty. Test-retest reliability was good: ICC = 0.69 (95% …

Validity Of The Early Activity Scale For Endurance And The 6-Minute Walk Test For Children With Cerebral Palsy., Alyssa Laforme Fiss, Lynn Jeffries, Allison Yocum, Sarah Westcott Mccoy, On Track Study Team

Physical Therapy Publications

PURPOSE: This study aimed to describe Early Activity Scale for Endurance (EASE) scores and 6-minute walk test (6MWT) distances of children with cerebral palsy (CP) by functional ability level, sex, and age and to examine the convergent validity of the 2 tests.

METHODS: A total of 708 participants with CP, Gross Motor Function Classification System (GMFCS) levels I to V, completed the EASE, and 376 of the study participants (3-12years), GMFCS levels I to III, completed the 6MWT.

RESULTS: Children with CP vary in EASE scores and 6MWT distances based on GMFCS level and, to a lesser extent, age. The …

Longitudinal Trajectories And Reference Centiles For The Impact Of Health Conditions On Daily Activities Of Children With Cerebral Palsy., Doreen J Bartlett, Jan Willem Gorter, Lynn M Jeffries, Lisa Avery, Steven E Hanna, On Track Study Team

Physical Therapy Publications

AIM: First, to describe the impact of health conditions on daily activities over time in children with cerebral palsy (CP) and to create age-specific reference centiles. Second, to determine the amount of change typical over a 1-year period, across Gross Motor Function Classification System (GMFCS) levels.

METHOD: A prospective, cohort design, with five assessments over 2 years, involved 708 children with a confirmed diagnosis of CP participating in the On Track Study (396 males, 312 females; mean age 6y [SD 2y 7mo]; range 18mo-12y at first assessment; 32.1% in GMFCS level I, 22.7% in GMFCS level II, 11.2% in GMFCS …

Developmental Trajectories For The Early Clinical Assessment Of Balance By Gross Motor Function Classification System Level For Children With Cerebral Palsy., Alyssa Laforme Fiss, Sarah Westcott Mccoy, Doreen Bartlett, Lisa Avery, Steven E Hanna, On Track Study Team

Physical Therapy Publications

Background: Children with cerebral palsy (CP) characteristically present with impairments in balance. Currently, the pattern and timing of the development of balance ability have not been described for children with CP of varying Gross Motor Function Classification System (GMFCS) levels.

Objective: The purpose of this study was to document longitudinal developmental trajectories in a measure of balance, the Early Clinical Assessment of Balance (ECAB) scores, along with age-specific reference percentiles and the amount of change typical over a 1-year period for children within different GMFCS levels.

Design: The design was a longitudinal cohort study.

Methods: Participants included 708 children with …

Developmental Trajectories And Reference Percentiles For Range Of Motion, Endurance, And Muscle Strength Of Children With Cerebral Palsy., Lynn M Jeffries, Alyssa Laforme Fiss, Sarah Westcott Mccoy, Doreen Bartlett, Lisa Avery, Steven Hanna

Physical Therapy Publications

BACKGROUND: Children with cerebral palsy (CP) frequently present with secondary impairments in spinal alignment and extremity range of motion, endurance for activity, and muscle strength. Creation of developmental trajectories for these impairments will help guide clinical decision-making.

OBJECTIVE: For children in each level of the Gross Motor Function Classification System (GMFCS) this study aimed to: (1) create longitudinal developmental trajectories for range of motion (Spinal Alignment and Range of Motion Measures [SAROMM]), endurance (Early Activity Scale for Endurance [EASE]), and functional strength (Functional Strength Assessment [FSA]); and (2) develop age-specific reference percentiles and amount of change typical over 1 year …

Developmental Trajectories And Reference Percentiles For The 6-Minute Walk Test For Children With Cerebral Palsy., Alyssa Laforme Fiss, Lynn Jeffries, Kristie Bjornson, Lisa Avery, Steven Hanna, Sarah Westcott Mccoy

Physical Therapy Publications

PURPOSE: The purposes of this study were to document longitudinal developmental trajectories in 6-minute walk test (6MWT) distances and to develop age-specific reference percentiles for children across different Gross Motor Function Classification System (GMFCS) levels.

METHODS: A TOTAL OF: 456 children with cerebral palsy ages 3 to 12 years of, GMFCS levels I to III participated. Children's motor function was classified on the GMFCS, and children completed the 6MWT 2 to 5 times in 2 years.

RESULTS: Longitudinal developmental trajectories support that 6MWT distances increase with age followed by a tapering, as children approach their functional limit relative to their …

Fatigue In Adults With Cerebral Palsy: A Three-Year Follow-Up Study., Irene L B Oude Lansink, Patrick G Mcphee, Laura Kristine Brunton, Jan Willem Gorter

Physical Therapy Publications

OBJECTIVES: To describe the course of fatigue over a 3-year follow-up period in adults with cerebral palsy and to investigate the association of known determinants of fatigue (i.e. demographic characteristics and/or body composition) with change in fatigue.

METHODS: Forty-one adults with cerebral palsy from a previous study of fatigue were invited to participate in a follow-up study. Twenty-three adults with cerebral palsy (Gross Motor Function Classification System (GMFCS) levels I-V; mean age 38 years 2 months, standard deviation (SD) 14 years 1 month)) agreed to participate (convenience sample). Fatigue was measured with the Fatigue Impact and Severity Self-Assessment (FISSA, range …

Stability Of The Gross Motor Function Classification System, Manual Ability Classification System, And Communication Function Classification System., Robert J Palisano, Lisa Avery, Jan Willem Gorter, Barbara Galuppi, Sarah Westcott Mccoy

Physical Therapy Publications

AIM: To determine the stability of the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) over 1-year and 2-year intervals using a process for consensus classification between parents and therapists.

METHOD: Participants were 664 children with cerebral palsy (CP), 18 months to 12 years of age, one of their parents, and 90 therapists. Consensus between parents and therapists on level of function was ≥92% for the GMFCS, MACS, and CFCS. A linearly weighted kappa coefficient of ≥0.75 was the criterion for stability.

RESULTS: Kappa coefficients varied from 0.76 to 0.88 for …

Descriptive Report Of The Impact Of Fatigue And Current Management Strategies In Cerebral Palsy., Laura K Brunton

Physical Therapy Publications

Purpose: Describe the impact of fatigue and self-management practices for adolescents and young adults with cerebral palsy (CP).

Methods: Survey of 124 people with CP with the Fatigue Impact and Severity Self-Assessment (FISSA).

Results: People in GMFCS Level I experienced little impact of fatigue with high proportions of this group disagreeing to statements about fatigue impacting their general activities, mobility and social activities. People in GMFCS Levels II-V reported impact of fatigue on activities. Differences between groups were evident in questions related to fatigue interference with length of time for physical activity and with motivations to participate in social …

Interrelationships Of Functional Status And Health Conditions In Children With Cerebral Palsy: A Descriptive Study., Doreen Bartlett, Emily Dyszuk, Barbara Galuppi, Jan Willem Gorter

Physical Therapy Publications

PURPOSE: To examine the relationship among the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS) in children with cerebral palsy (CP) and to determine the average number and effect of health conditions.

METHODS: Participants were 671 children with CP aged 2 to 12 years from Canada and the United States. Cross-tabulation of functional classifications and averages were computed for the number and impact of health conditions and comparisons among groups.

RESULTS: A total of 78 of the 125 possible classification combinations were recorded. Most frequent were GMFCS I, MACS …

Understanding Participation Of Children With Cerebral Palsy In Family And Recreational Activities., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy

Physical Therapy Publications

AIMS: The primary aim of this study was to determine the effect of age, sex, gross motor, manual ability, and communication functions on the frequency and enjoyment of children's participation in family and recreational activities. The secondary aim was to determine the relationships between motor and communication functions and participation.

METHODS: Participants were 694 children, 1.5-12 years old, with cerebral palsy (CP) and their parents across the US and Canada. Parents rated children's frequency and enjoyment of participation using the Child Engagement in Daily Life measure. Parents and therapists identified children's level of function using Gross Motor Function Classification System …