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Relationship between functional lower limb capacity and falls in ambulant children with cerebral palsy
Laura A Bentley1, Sarah K Ashcroft2, Sarah Reedman2
1Child Health Research Centre, The University of Queensland, Australia.
Insights
Ambulant children with cerebral palsy (CP) experience frequent falls, with poorer performance in sit-to-stand and step-up tests indicating higher fall risk. These findings highlight key functional measures for fall prevention strategies in children with CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Ambulant children with cerebral palsy (CP) face a significant risk of falls.
- Identifying factors associated with falls is crucial for intervention in this population.
Purpose of the Study:
- To investigate parent-reported falls in ambulant children with CP.
- To determine associations between lower limb functional measures and fall frequency.
- To establish clinical thresholds for predicting higher fall rates.
Main Methods:
- Explored falls in 66 children with CP (GMFCS I-III).
- Assessed associations between lower limb functional tests (e.g., Sit-to-Stand, Lateral Step-up) and fall numbers.
- Utilized ROC analysis to identify fall risk thresholds.
Main Results:
- 81% of children reported at least one fall in the past month; 44% sustained injuries.
- Children in GMFCS level II experienced the most falls.
- Reduced performance in Sit-to-Stand, Lateral Step-up, and Kneel-to-Stand tests correlated with increased fall frequency.
Conclusions:
- Ambulant children with CP are highly susceptible to falls.
- Impaired performance in specific lower limb balance assessments is linked to higher fall rates, suggesting targets for clinical assessment and intervention.
Aim:
Ambulant children with cerebral palsy (CP) are at a high risk of falls. It is important to identify characteristics associated with increased falls and understand which clinical measures are associated with falls in this population.
Method:
This study explored parent-reported falls of 66 children with CP (Gross Motor Function Classification System [GMFCS] I - III) and the associations between lower limb functional measures (6-Minute Walk Test, Muscle Power Sprint Test, 10 Metre Walk Test, Sit-to-Stand, Lateral Step-up, Kneel-to-Stand) and the number of falls. Receiver operating characteristic (ROC) curve analysis identified score thresholds for the likelihood of falling more than average.
Results:
81% of children fell at least once in the previous month, with an average of 11 falls and 44% children who fell were injured. Children in GMFCS level II had the greatest number of falls. Poorer performance on Sit-to-Stand, Lateral-Step-Up and Kneel-To-Stand were associated with fall frequency. ROC thresholds for likelihood of above average fall frequency were identified for lateral step-up best side (score ≤17), sit-to-stand (score ≤15) and kneel-to-stand best side (score ≤ 4).
Interpretation:
Ambulant children with CP are at high risk of falls. Poor performance in several lower limb assessments incorporating balance ware associated with higher fall frequency.
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