Turkish Journal of Physical Medicine and Rehabilitation 2006 , Vol 52 , Num 3
Factors Affecting the Functional Level in Children with Cerebral Palsy
Bülent Hazneci 1 ,Sebahattin Vurucu 1 ,Fatih Örs 2 ,Arif Kenan Tan 1 ,Serhat Gençdoğan 1 ,Kemal Dinçer 1 ,Tunç Alp Kalyon 3
1 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
2 Gülhane Askeri Tıp Akademisi, Fizik Tedavi ve Rehabilitasyon ve Radyoloji Anabilim Dalı, Ankara
3 T.C. Sağlık Bakanlığı Akupunktur Bilim Komisyonu Üyesi, Ankara

Objective: To determine the differences in functional ability levels regarding gross motor function classification system (GMFCS), type of cerebral palsy (CP), severity of spasticity and to investigate factors affecting the presence of secondary pathologies such as hip pathology (HP) and scoliosis in children with CP.
 

Materials and Methods: 136 children with CP were included in the study. Age, gender, type of CP, presence of epilepsy and mental retardation (MR) of all patients were recorded as demographic findings. Functional disability level as to gross motor function classification system (GMFCS) and ability of managing daily life activities as to gross motor functional measurement (GMFM) of patients were measured. Upper and lower extremity spasticity evaluation was performed by Modified Ashworth Scale (MAS). Obtained total MAS score was converted to index (MAS index). Presence of HP and scoliosis of all patients were determined by pelvis and dorsolumbar spine X-rays. 
 

Results: When comparing patients with MAS score index above and below 3 as to GMFM total score, statistically significant difference was obtained in favor of those having MAS score index below 3 [mean (SD): 71.41 (25.76); 27.16 (24.36), Z:-7.37, p<0.001, consecutively]. Statistically significant difference was obtained in favor of patients with MAS score index above 3 in terms of HP and scoliosis presence ( c2:18.08, p<0.001, c2:6.57, p:0.011, consecutively). Between age, GMFCS and MAS index with HP ; between age, type of CP, GMFCS and MAS index with scoliosis, statistically significant positive correlation was obtained (p<0.05).
 

Conclusion: The results of this study shows that the severity of spasticity affects daily living activities negatively and togetherness of HP and scoliosis formation with increase in severity of spasticity is more common. On the other hand, presence of secondary pathologies such as MR and epilepsy deteriorate functional ability level significantly. 

Keywords : Functional level, gross motor function classification system, gross motor functional measurement, cerebral palsy