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Limb distribution, motor impairment, and functional classification of cerebral palsy

Published online by Cambridge University Press:  07 July 2004

Jan Willem Gorter ,
Peter L Rosenbaum ,
Steven E Hanna ,
Robert J Palisano ,
Doreen J Bartlett ,
Dianne J Russell ,
Stephen D Walter ,
Parminder Raina ,
Barbara E Galuppi  and
Ellen Wood
Jan Willem Gorter
Affiliation:
Rehabilitation Centre De Hoogstraat, Utrecht, the Netherlands.
Peter L Rosenbaum
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada.
Steven E Hanna
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada.
Robert J Palisano
Affiliation:
Programs in Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA.
Doreen J Bartlett
Affiliation:
School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
Dianne J Russell
Affiliation:
School of Rehabilitation Science, McMaster University, Canada.
Stephen D Walter
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada.
Parminder Raina
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada.
Barbara E Galuppi
Affiliation:
Ontario Motor Growth Study, CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.
Ellen Wood
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
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Abstract

This study explored the relationships between the Gross Motor Function Classification System (GMFCS), limb distribution, and type of motor impairment. Data used were collected in the Ontario Motor Growth study, a longitudinal cohort study with a population-based sample of children with cerebral palsy (CP) in Canada (n=657; age 1 to 13 years at study onset). The majority (87.8%) of children with hemiplegia were classified as level I. Children with a bilateral syndrome were represented in all GMFCS levels, with most in levels III, IV, and V. Classifications by GMFCS and ‘limb distribution’ or by GMFCS and ‘type of motor impairment’ were statistically significantly associated (Pearson's χ2p<0.001), though the correlation for limb distribution (two categories) by GMFCS was low (tau-b=0.43). An analysis of function (GMFCS) by impairment (limb distribution) indicates that the latter clinical characteristic does not add prognostic value over GMFCS. Although classification of CP by impairment level is useful for clinical and epidemiological purposes, the value of these subgroups as an indicator of mobility is limited in comparison with the classification of severity with the GMFCS.

Type
Original Articles
Information
Developmental Medicine and Child Neurology , Volume 46 , Issue 7 , July 2004 , pp. 461 - 467
Copyright
© 2004 Mac Keith Press

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