Children with cerebral palsy and preferred functional mobility method: A population-based cross-sectional study

Abstract

Background: Cerebral palsy is a complex disorder that can cause several impairments affecting the children’s mobility. Previous studies have mostly investigated specific interventions or gross motor capability of children, but very few studies have explored the children’s preferred mobility methods in their daily environments. Aim: The aim of this study was to describe the preferred mobility methods in a population of children with CP, in relation to age, CP characteristics, and CP related motor impairments. Method and material: The study includes population-based longitudinal data from one consent-based registry, the national motor follow-up program for children with CP (CPOP), but is designed as a crosssectional study. The research participants consist of 773 children whom all were 4 years or older. Data were collected from 01.01.2002-31-12.2017. Results: There were statistically significant associations between functional mobility scale (FMS), subtype of CP, severity of CP (GMFCS), spasticity and joint mobility restrictions. No significant associations were found for FMS and age. The majority of children had a low severity of CP and walked independently across home, school and community environments. Amongst the children with a higher level of CP, an increase in wheelchair use was seen. There were a tendency of fewer children walking independently and more using a wheelchair compared from the home to communal environments. Almost all of the children with high severity of CP had bilateral spasticity, whereas unilateral spasticity encountered for most of the more selfmobilising children. Conclusion: The majority of children walked independently across their home, school and communal environments. The largest proportion of children walking independently had GMFCS level I, whereas the largest proportion of wheelchair users had GMFCS level IV and V. There was a positive correspondence between the functional mobility scale and GMFCS levels, as well as that neither spasticity nor joint mobility restrictions were hallmarks in terms of preventing children from walking independently across 5, 50 and 500-meter distances