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Published on: January 11, 2016
Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities
Sigrid Ostensjø1, Eva Brogren Carlberg, Nina K Vøllestad
1Faculty of Health Sciences, Oslo University College, Oslo, Norway. Sigrid.Ostensjo@hf.hio.no
Insights
This study found that loss of selective motor control significantly impacts gross motor function in children with cerebral palsy (CP). While spasticity and range of motion deficits are important, selective motor control is a key factor for daily activities.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Biomedical Engineering
Background:
- Cerebral palsy (CP) presents complex motor challenges, including spasticity, range of motion (ROM) deficits, and impaired selective motor control.
- Understanding the interplay between these impairments and their impact on functional outcomes is crucial for effective intervention.
Purpose of the Study:
- To assess the distribution of spasticity, ROM deficits, and selective motor control problems in children with CP.
- To examine the relationships between these impairments and gross motor function and everyday activities.
- To identify key predictors of gross motor function and activity accomplishment in children with CP.
Main Methods:
- Ninety-five children with CP (mean age 58 months) were evaluated using standardized measures: Modified Ashworth Scale (MAS) for spasticity, passive ROM, Selective Motor Control scale (SMC), Gross Motor Function Measure (GMFM), and Pediatric Evaluation of Disability Inventory (PEDI).
- Participants represented various CP types (hemiplegia, diplegia, quadriplegia, dyskinetic, mixed) and spanned all Gross Motor Function Classification System (GMFCS) levels.
Main Results:
- A wide variability in correlations between MAS, ROM, and SMC indicated a complex relationship between spasticity, ROM, and selective motor control.
- Loss of selective motor control appeared to interfere with gross motor function more significantly than spasticity or ROM deficits.
- Motor impairments were only one component predicting gross motor function; the ability to perform gross motor tasks was the strongest predictor of activity accomplishment.
Conclusions:
- Measuring spasticity and ROM across multiple muscles and joints is essential for a comprehensive assessment in children with CP.
- Selective motor control is a critical factor influencing gross motor function and participation in everyday activities.
- Interventions targeting selective motor control may be vital for improving functional outcomes in children with cerebral palsy.
Abstract:
In this study we assessed the distribution of spasticity, range of motion (ROM) deficits, and selective motor control problems in children with cerebral palsy (CP), and examined how these impairments relate to each other and to gross motor function and everyday activities. Ninety-five children (55 males, 40 females; mean age 58 months, SD 18 months, range 25 to 87 months) were evaluated with the modified Ashworth scale (MAS), passive ROM, the Selective Motor Control scale (SMC), the Gross Motor Function Measure (GMFM), and the Pediatric Evaluation of Disability Inventory (PEDI). Types of CP were hemiplegia (n=19), spastic diplegia (n=40), ataxic diplegia (n=4), spastic quadriplegia (n=16), dyskinetic (n=9), and mixed type (n=7). Severity spanned all five levels of the Gross Motor Function Classification System (GMFCS). The findings highlight the importance of measuring spasticity and ROM in several muscles and across joints. Wide variability of correlations of MAS, ROM, and SMC indicates a complex relationship between spasticity, ROM, and selective motor control. Loss of selective control seemed to interfere with gross motor function more than the other impairments. Further analyses showed that motor impairments were only one component among many factors that could predict gross motor function and everyday activities. Accomplishment of these activities was best predicted by the child's ability to perform gross motor tasks.
