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Sitting and standing performance in a total population of children with cerebral palsy: a cross-sectional study
Elisabet Rodby-Bousquet1, Gunnar Hägglund
1Department of Orthopaedics, Lund University, University Hospital, Lund, Sweden. elisabet.rodby_bousquet@med.lu.se
Insights
Most children with cerebral palsy (CP) can sit and stand independently. The Gross Motor Function Classification System (GMFCS) effectively predicts sitting and standing abilities in children with CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) affects children's motor function, impacting daily activities like sitting and standing.
- Understanding sitting and standing performance is crucial for healthcare planning and predicting functional outcomes in children with CP.
- A Swedish healthcare program initiated in 1994 collects annual data on children with CP, including their sitting and standing abilities.
Purpose of the Study:
- To analyze sitting and standing performance in a comprehensive population of children with cerebral palsy (CP).
- To investigate the relationship between sitting and standing abilities and factors such as the Gross Motor Function Classification System (GMFCS), CP subtype, and age.
- To inform healthcare planning and predict future functional capabilities in children with CP.
Main Methods:
- A cross-sectional study analyzed data from 562 children with CP (aged 3-18 years) in southern Sweden (born 1990-2005).
- Data on independence in sitting, standing, sit-to-stand, and stand-to-sit, along with the use of support or assistive devices, were collected.
- Analysis correlated these functional abilities with GMFCS levels, CP subtype, and age.
Main Results:
- A majority of children (57-63%) used standard chairs and could perform sitting and standing tasks independently.
- Adaptive seating was used by 42%, and external support was utilized by 18-31% of children.
- The use of adaptive seating and assistive devices significantly increased with higher GMFCS levels and varied by CP subtype, with more support needed in younger children (3-6 years).
Conclusions:
- Approximately 60% of children with CP (aged 3-18) can sit and stand independently.
- When including adaptive seating and external support, nearly all children can sit (99%) and stand (96%), with high percentages able to stand up (81%) and sit down (81%).
- The GMFCS classification system is a reliable predictor of sitting and standing performance in children with CP.
Background:
Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP) is of interest for health care planning and for prediction of future ability in the individual child. In 1994, a register and a health care programme for children with CP in southern Sweden was initiated. In the programme information on how the child usually sits, stands, stands up and sits down, together with use of support or assistive devices, is recorded annually.
Methods:
A cross-sectional study was performed, analysing the most recent report of all children with CP born 1990-2005 and living in southern Sweden during 2008. All 562 children (326 boys, 236 girls) aged 3-18 years were included in the study. The degree of independence, use of support or assistive devices to sit, stand, stand up and sit down was analysed in relation to the Gross Motor Function Classification System (GMFCS), CP subtype and age.
Result:
A majority of the children used standard chairs (57%), could stand independently (62%) and could stand up (62%) and sit down (63%) without external support. Adaptive seating was used by 42%, external support to stand was used by 31%, to stand up by 19%, and to sit down by 18%. The use of adaptive seating and assistive devices increased with GMFCS levels (p < 0.001) and there was a difference between CP subtypes (p < 0.001). The use of support was more frequent in preschool children aged 3-6 (p < 0.001).
Conclusion:
About 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support. Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position. The GMFCS classification system is a good predictor of sitting and standing performance.
