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Published on: January 12, 2019
Lower limb functioning and its impact on quality of life in ambulatory children with cerebral palsy
Ellen Jaspers1, An Verhaegen, Fien Geens
1KU Leuven, Department of Rehabilitation Sciences, Belgium; Department of Health Sciences and Technology, ETH Zurich, Switzerland.
Insights
Children with cerebral palsy (CP) experience motor challenges impacting their quality of life (QOL). Gait pathology significantly affects QOL, with gait speed being more critical for parents than children.
Area of Science:
- Pediatric Rehabilitation
- Movement Science
- Quality of Life Research
Background:
- Children with cerebral palsy (CP) face daily motor challenges, particularly affecting gait.
- These gait impairments can significantly impact their overall quality of life (QOL).
Purpose of the Study:
- To evaluate how gross motor and gait function influence QOL in ambulatory children with CP attending mainstream schools.
- To understand the relationship between specific impairments and perceived QOL.
Main Methods:
- Utilized the CP QOL-Child questionnaire for parent/proxy and child self-reports.
- Collected data on 81 ambulatory children with CP (mean age 10.5 years) regarding therapy, lower limb impairments, and gait function.
Main Results:
- Child self-reported QOL scores were higher than parent/proxy scores.
- Lower limb spasticity and frequent BTX-A injections correlated with poorer QOL in pain and disability domains.
- Severity of gait pathology adversely impacted QOL perception for both children and parents, with gait speed being more important to parents.
Conclusions:
- Both children and parents identified gait pathology as a key factor negatively affecting QOL.
- Gait speed emerged as a more significant factor for parental QOL perception compared to child self-perception.
Background:
Children with cerebral palsy (CP) are confronted on a daily basis with their motor problems affecting gait, which might impact on their quality of life (QOL).
Aim:
The goal of this study was to evaluate the impact of gross motor and gait function on QOL in ambulatory children with CP attending regular school.
Methods:
A condition-specific questionnaire (CP QOL-Child), including a parent/proxy and child self-report, was used to assess the relation between patient characteristics, lower limb impairments and functioning, and the different aspects of the child's QOL. Data on therapy management, lower limb impairments, and gross motor and gait function was collected for 81 children with CP (10.5 ± 3.0 years). CP QOL-Child questionnaires were completed by a parent/proxy for all 81 children and by 39 of the children over 9 years.
Results:
The mean self-reported QOL score (78.2 ± 9.6) was significantly higher than the mean parent/proxy reported score (73.9 ± 10.2). Lower limb spasticity and higher frequency of BTX-A injections correlated with worse scores for the pain and impact of disability domain. Results further showed the adverse impact of the severity of gait pathology on QOL perception for the parents/proxy and the child self-report. Gait speed was an important factor for the parents/proxy, though correlated less with self-perceived QOL for the children.
Conclusions:
Children and parents identified similar factors that adversely affect QOL, whereby the amount of gait pathology was shown to play a crucial role. Only gait speed seemed to be of higher importance for the parents compared to the children.
