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Correlation between ICIDH handicap code and Gross Motor Function Classification System in children with cerebral
1Department of Pediatrics, Göteborg University, Queen Silvia's University Hospital, Sweden.
Insights
The Gross Motor Function Classification System (GMFCS) closely aligns with the International Classification of Impairments, Disabilities and Handicap (ICIDH) for children with cerebral palsy (CP). GMFCS is a faster, retrospective tool for assessing gross motor function.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Neurology
Background:
- Cerebral palsy (CP) classification systems are crucial for understanding functional limitations.
- The International Classification of Impairments, Disabilities and Handicap (ICIDH) and the Gross Motor Function Classification System (GMFCS) are widely used tools.
- Comparing these systems can refine assessment and management strategies for children with CP.
Purpose of the Study:
- To apply the ICIDH and GMFCS in parallel to a population-based series of children with CP.
- To evaluate the correlation and similarity in disability grading between the two classification systems.
- To determine the clinical utility and efficiency of each system in assessing children with CP.
Main Methods:
- Retrospective collection of data from 116 children with CP aged 5-6 years.
- Utilized birth characteristics, gross motor function data, and handicap levels from medical records.
- Applied both ICIDH and GMFCS to classify the severity of disability and handicap.
Main Results:
- Significant correlations were found between high handicap scores, GMFCS levels, and the presence of learning disability, epilepsy, and obvious CP etiology.
- A strong correlation (r = 0.95, p<0.0001) was observed between the ICIDH handicap code and GMFCS, particularly in mobility.
- A striking similarity in disability grading was noted between the ICIDH handicap code and GMFCS.
Conclusions:
- The GMFCS demonstrates a striking similarity to the ICIDH handicap code in grading disability for children with CP.
- GMFCS is considerably less time-consuming and suitable for retrospective evaluation.
- The ICIDH handicap code provides a more comprehensive profile but requires more detailed information.
Abstract:
The aim of this study was to apply the International Classification of Impairments, Disabilities and Handicap (ICIDH; WHO 1980) parallel to the Gross Motor Function Classification System (GMFCS; Palisano et al. 1997) in a population-based series of children with cerebral palsy (CP). Of the 116 children studied, birth characteristics, data on gross motor function, and level of handicap at 5 to 6 years of age, were retrospectively collected from medical records and documentation made by rehabilitation team members. Low handicap scores and mild levels of gross motor disability were present in children with hemiplegic CP, moderate scores in children with diplegic CP, simple ataxia, and athetotic CP, and high scores in children with dystonic CP and tetraplegic CP. A significant correlation was found between high handicap scores as well as high levels on the GMFCS and the presence of learning disability, epilepsy, and obvious aetiology of CP. A strong correlation was found between the handicap code and the GMFCS, the strongest concerning the dimension of mobility (r = 0.95,p<0.0001). A striking similarity in the grading of disability was present between the ICIDH handicap code and the GMFCS. The GMFCS is considerably less time-consuming and can be evaluated retrospectively. The handicap code requires more detailed information and is more useful for a comprehensive profile of the child.