Cerebral palsy in Victoria: Motor types, topography and gross motor function

Howard, Jason; Soo, Brendan; Graham, H Kerr; Boyd, Roslyn N.; Reid, Susan M; Lanigan, Anna; Wolfe, Rory; Reddihough, Dinah

doi:10.1111/j.1440-1754.2005.00687.x

Cited by 187 publications

(191 citation statements)

References 20 publications

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“…In the studies of Beckung et al 19 the participants were divided according to motor type and the spastic ones were divided according to topography; quadriplegic spastic ones were all level V, dyskinetic children were classified from level I to V, with a predominance of level III and the ataxic ones were classified in levels I and II; there were no cases of mixed cerebral palsy. himmelmann et al 25 had similar results, in that quadriplegic spastic children were classified in levels IV and V and most of them were level V; diskinetic children were classified in all levels but the majority was levels IV and V. The study of howard et al 16 reported that most of quadriplegic spastic children were level IV and V, diskinetic children were levels II, III and IV and the mixed ones were all levels; the ataxic children were classified in the first three levels and the hypotonic ones were all levels except level II. regarding the relation between motor level and age, our study found a certain tendency to association through Fisher' s exact test (p=0.075) although it did not present significance.…”

Section: Discussionsupporting

confidence: 66%

“…The child was 8 months old and had late development; it is possible that such condition reaches the lowest lower limbs because of its neurological maturation. himmelmann et al 25 found out cases of hemiplegia in all motor levels; Beckung et al 19 established that the cases varied between levels I and IV; howard et al 16 found levels I, II, III and V and Voorman et al 18 classified the cases under levels I, II and III. diplegic children in this study were similar (with no significant difference) in the first four levels and there were no examples of level V; in their study Voorman et al 18 had the same results and only 3 cases (6.4%) were level V. In their study himmelmann et al 25 had diplegic children in all levels, most of them were level II (37.5%) and only 4.9% of the children were classified in level V. Similar results were found in the study of Beckung et al 19 in which they observed that most children were classified in the first two levels while only 4% were classified in level V. The results in the study of howard et al 16 were very similar in the first three levels; only 4 cases (5%) were level IV and no diplegic children were level V.…”

Section: Discussionmentioning

confidence: 99%

“…Quadriplegia is the type of dysfunction most often cited in the international 16 and national literature 17 . This form of cP affecting muscular strength in different levels results from its location associated with the cause (the most frequent is hypoxic-ischemic encephalopathy) followed by defects of cortical cerebral development) 5 .…”

Section: Discussionmentioning

confidence: 99%

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Classification of cerebral palsy: association between gender, age, motor type, topography and Gross Motor Function

Pfeifer

Silva

Funayama

et al. 2009

Arq. Neuro-Psiquiatr.

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-The goal of this study was to assess the relation between gender, age, motor type, topography and gross motor function, based on the Gross Motor Function System of children with cerebral palsy. Trunk control, postural changes and gait of one hundred children between 5 months and 12 years old, were evaluated. There were no significant differences between gender and age groups (p=0.887) or between gender and motor type (p=0.731). In relation to body topography most children (88%) were spastic quadriplegic. Most hemiplegics children were rated in motor level I, children with diplegia were rated in motor level III, and quadriplegic children were rated in motor level V. Functional classification is necessary to understand the differences in cerebral palsy and to have the best therapeutic planning since it is a complex disease which depends on several factors.Key wordS: cerebral palsy, disabled children, motor skills, classification system, gross motor function.Classificação da paralisia cerebral: associação entre gênero, idade, tipo motor, topografia e função Motora Grossa resumo -este estudo teve como objetivo avaliar a relação entre gênero, idade, tipo motor, topografia e Função Motora Grossa, baseado no Sistema de Função Motora Grossa em crianças com paralisia cerebral. Participaram desta pesquisa 100 crianças com idade entre 5 meses a 12 anos que foram observadas em relação ao controle de tronco, trocas posturais e marcha. Não houve diferenças significativas entre gêneros e grupos etários (p=0,887) e entre gênero e tipo motor (p=0,731). em relação à topografia corporal, houve predomínio de crianças com quadriplegia, sendo que a maioria (88%) era do tipo espástico. Quanto ao nível motor, as crianças hemiplégicas pertenciam em sua maioria ao nível I, as diplégicas ao nível III e as quadriplégicas ao nível V. Sendo a paralisia cerebral uma condição complexa que depende de diversos fatores, beneficia-se de classificações funcionais para compreensão da diversidade e melhor planejamento terapêutico. PAlAVrAS-chAVe: paralisia cerebral, criança deficiente, sistema de classificação, habilidade motora, função motora grossa. cerebral palsy (cP) is described as a range of disorders of motor and postural development which causes functional limitations attributed to non-progressive disorders that occur in fetal development or child' s brain 1 . It has traditionally been described based on the kind of damage (spasticity, dyskinesia and ataxia) and its location, or topography (hemiplegia, diplegia and tetraplegia) 2 . Until recently there were not standardized methods to classify cerebral palsy in relation to subtypes and severity of motor impairments 3-5 . The Gross Motor Function System (GMFcS) 6 was developed to classify functional mobility in children diagnosed with cerebral palsy by levels of functional mobility and consists of five levels ranging from I, which includes children with minimal or no dysfunction relative to community mobility to V, which includes children who are totally dependent and need help to mo...

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Classification of cerebral palsy: association between gender, age, motor type, topography and Gross Motor Function

Pfeifer

Silva

Funayama

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…3 For this study we took advantage of data from two prospective longitudinal studies of gross motor development of children with CP. Although one study is a clinic-based cohort in the Netherlands (PERRIN CP 0)5 study) and the other a population-based study in Canada (OMG study) the distribution over the five GMFCS levels is good, representing the spectrum of severity in CP as seen in larger population based studies 16,17 The inclusion of children from North America and Europe and their distribution over the five levels of the GMFCS provides preliminary evidence that the findings can be generalized to all children with CP less than 2 years of age. We did not study the interrater reliability of the GMFCS in this study, but as reclassifications were seen both in children classified by the same observer and in children classified by different observers at Time 1 and Time 2, we do not think that this has influenced our results.…”

Section: Movements In and Outmentioning

confidence: 99%

Use of the GMFCS in infants with CP: the need for reclassification at age 2 years or older

Gorter

Ketelaar

Rosenbaum

et al. 2008

Develop Med Child Neuro

134

103

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The stability of the Gross Motor Function Classification System (GMFCS) over time is described in 77 infants (41 boys, 36 girls) with cerebral palsy (CP; mean age 19.4mo [SD 1.6 mo]; 27 unilateral spastic, 42 bilateral spastic, eight dyskinetic type) and in the same children at follow‐up at age 2 to 4 years. The overall level of agreement over time (linear weighted kappa) was 0.70 (95% confidence interval [CI] 0.61−0.79). The overall percentage of children whose GMFCS level changed one or two levels was 42%, of which the majority were reclassified to a less functional level (McNemar’s Chi2 test p=0.11). The chance that children initially classified in the combination of GMFCS Levels I, II, and III would subsequently be classified in the same level in early childhood was 96% (positive predictive value [PPV] 0.96, 95% CI 0.85−0.99), whereas the PPV for the combination of Levels I and II was 0.88, 95% CI 0.70−0.96. These findings indicate that GMFCS classification in infants is less precise than classification over time in older children. In conclusion, children can be classified by the GMFCS early on, but there is a need for reclassification at age 2 or older as more clinical information becomes available.

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“…Quanto à realização de tarefas cognitivas e comportamentais, os hemiplégicos também apresentaram os melhores resultados nas análises de Scheffe e Posthoc 27 .…”

Section: Funcionalidadeunclassified

Prognóstico motor e perspectivas atuais na paralisia cerebral

Rebel

Rodrigues

Araújo

et al. 2010

J. Hum. Growth Dev.

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A paralisia cerebral é uma sequela de agressão encefálica caracterizada por transtorno motor não evolutivo quanto à sua lesão. De acordo com o local da lesão pode provocar diferentes seqüelas que resultam em incapacidade funcional. OBJETIVO: revisar de forma não sistemática sobre o tema paralisia cerebral, enfocando o seu prognóstico motor, incluindo expectativa de vida e funcionalidade. MÉTODO: utilização das bases de dados Medline e LILACS, dos últimos quinze anos, com os unitermos paralisia cerebral, quadriplegia, diplegia, hemiplegia, prognóstico. RESULTADOS: foram listados 474 artigos científicos, sendo selecionados para esta revisão 34 artigos com base em: título, resumo, assunto, originalidade e disponibilidade de acesso pelo portal da CAPES. Foram identificadas as variáveis que podem influenciar o prognóstico motor nas crianças com paralisia cerebral. O prejuízo motor das crianças com paralisia cerebral está diretamente relacionado com o nível de gravidade da paralisia cerebral, assistência terapêutica e o tipo apresentado pelas crianças. Os pacientes com hemiplegia resultante de paralisia cerebral apresentam um prognóstico motor mais favorável comparado aos diplégicos e quadriplégicos.

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Cerebral palsy in Victoria: Motor types, topography and gross motor function

Cited by 187 publications

References 20 publications

Classification of cerebral palsy: association between gender, age, motor type, topography and Gross Motor Function

Classification of cerebral palsy: association between gender, age, motor type, topography and Gross Motor Function

Use of the GMFCS in infants with CP: the need for reclassification at age 2 years or older

Prognóstico motor e perspectivas atuais na paralisia cerebral

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