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The effect of functional independence levels on sleep and constipation in children with cerebral palsy
Elif Irem Gunaydin1,2, Aysenur Tuncer3
1Hasan Kalyoncu University, Institute of Graduate Education, Division of Physiotherapy and Rehabilitation - Gaziantep, Turkey.
Insights
Children with cerebral palsy (CP) and lower functional independence experience worse sleep and constipation. Improving functional independence in CP management may alleviate these symptoms.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Sleep Medicine
Background:
- Cerebral palsy (CP) significantly impacts children's functional abilities.
- Sleep disturbances and constipation are common comorbidities in children with CP.
Purpose of the Study:
- To investigate the relationship between functional independence levels and sleep behavior in children with CP.
- To examine the association between functional independence and constipation severity in children with CP.
Main Methods:
- Cross-sectional observational study of 60 children (aged 4-18) with CP (GMFCS III-V).
- Utilized the Pediatric Functional Independence Scale (PFIS), Pediatric Sleep Questionnaire (PSQ), and Constipation Severity Scale (CSS).
- Exclusion criteria included specific surgeries, bowel diseases, congenital anomalies, recent Botox, uncontrolled epilepsy, and cardiopulmonary disease.
Main Results:
- A significant negative correlation was found between PFIS scores and PSQ scores (r=-0.303, p=0.019).
- A significant negative correlation was observed between PFIS scores and CSS scores (r=-0.342, p=0.007).
- Lower functional independence was associated with poorer sleep and increased constipation severity.
Conclusions:
- Reduced functional independence in children with CP is linked to heightened sleep problems and constipation.
- Interventions aimed at enhancing functional independence may offer a dual benefit for managing sleep and constipation in CP.
Objective:
The study aimed to examine the effect of functional independence levels on sleep behavior and constipation in children with cerebral palsy.
Methods:
This cross-sectional observational single-center study was carried out in a special rehabilitation center in Istanbul. Inclusion criteria were those aged between 4 and 18 years with Gross Motor Function Classification System III-IV-V functional independence levels. Those who had surgery concerning intestinal health, had a chronic infectious bowel disease, had congenital intestinal anomalies, had received botox treatment in the last 6 months, had uncontrolled epileptic seizures, had complained of constipation in the last 6 months, and had cardiopulmonary disease were excluded from the study. The sociodemographic characteristics of the participants and the Gross Motor Function Classification System were recorded. Pediatric Functional Independence Scale (Functional Independence Measure for Children) was used to measure the functional independence level, Pediatric Sleep Questionnaire was used to measure the level of sleep problems, and Constipation Severity Scale was used to measure constipation severity.
Results:
A total of 60 children who were diagnosed with cerebral palsy were included. According to Gross Motor Function Classification System, 46.7% of the cases were Level III, 35% were Level IV, and 18.3% were Level V. There was a negative moderate significant correlation between Functional Independence Measure for Children and Pediatric Sleep Questionnaire (r=-0.303; p=0.019) and between Functional Independence Measure for Children and Constipation Severity Scale (r=-0.342; p=0.007).
Conclusion:
We described that lower functional independence levels were related to worse sleep and constipation symptoms. The results suggest that effective strategies for developing functional independence levels may be beneficial for both sleep and constipation symptoms in the concept of cerebral palsy management.
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