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Examining mobility, independence, motor function, participation, and parental stress in a school-aged Turkish cerebral palsy population: a cross-sectional study

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Abstract

Aims

This study aimed to describe a school-aged Turkish cerebral palsy (CP) population in terms of gross motor function, mobility, independence, and participation, and to investigate parental stress.

Methods

Mobility (Functional Mobility Scale (FMS)), independence (Barthel Index (BI)), motor function (Gross Motor Function Measurement (GMFM)), functional classification (Gross Motor Function Classification System (GMFCS)), participation (Pediatric Outcome Data Collection Instrument (PODCI)), and parents’ stress (Parental Stress Scale (PSS)) of 100 school-aged children with CP aged 5–15 years old were evaluated. School-related difficulties and restrictions were also questioned.

Results

Of the 100 children with GMFCS levels I–V, almost half had independent mobility on level or all surfaces according to the FMS, with a relatively high GMFM score (72.8%), and above average BI (12 from 20), and PODCI Global Functioning (62.8%) scores. Strong-to-very strong correlations were determined between all test batteries. A mean score of 42.3 ± 9.92 out of 90 was obtained for parental stress with a weak correlation to the GMFCS and the child’s mobility distance according to family (p < 0.05).

Conclusions

Turkish school-aged children with CP displayed functional abilities that are above average besides experiencing restrictions in the school environment. Parents’ view on the physical condition of the school varied depending on functional and mobility levels of their children.

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References

  1. Bax MCO, Flodmark O, Tydeman C (2007) From syndrome toward disease. Dev Med Child Neurol 49:39–41. https://doi.org/10.1111/j.1469-8749.2007.tb12627.x

    Article  Google Scholar 

  2. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Jacobsson B (2007) A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 109(suppl 109):8–14. https://europepmc.org/abstract/med/17370477. Accessed 1 Nov 2018

    PubMed  Google Scholar 

  3. Aisen ML, Kerkovich D, Mast J, Mulroy S, Wren TA, Kay RM, Rethlefsen SA (2011) Cerebral palsy: clinical care and neurological rehabilitation. Lancet Neurol 10(9):844–852. https://doi.org/10.1016/S1474-4422(11)70176-4

    Article  PubMed  Google Scholar 

  4. Tieman BL, Palisano RJ, Gracely EJ, Rosenbaum PL (2004) Gross motor capability and performance of mobility in children with cerebral palsy: a comparison across home, school, and outdoors/community settings. Phys Ther 84(5):419–429. https://doi.org/10.1093/ptj/84.5.419

    Article  PubMed  Google Scholar 

  5. Palisano RJ, Tieman BL, Walter SD, Bartlett DJ, Rosenbaum PL, Russell D, Hanna SE (2003) Effect of environmental setting on mobility methods of children with cerebral palsy. Dev Med Child Neurol 45(2):113–120. https://doi.org/10.1017/S0012162203000215

    Article  PubMed  Google Scholar 

  6. Tieman BL, Palisano RJ, Gracely EJ, Rosenbaum PL, Chiarello LA, O'neil ME (2004) Changes in mobility of children with cerebral palsy over time and across environmental settings. Phys Occup Ther Pediatr 24(1–2):109–128. https://doi.org/10.1300/J006v24n01_05

    Article  PubMed  Google Scholar 

  7. Beckung E, Hagberg G (2002) Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol 44:309–316. https://doi.org/10.1017/S0012162201002134

    Article  PubMed  Google Scholar 

  8. Fauconnier J, Dickinson HO, Beckung E, Marcelli M, McManus V, Michelsen SI et al (2009) Participation in life situations of 8–12 year old children with cerebral palsy: cross sectional European study. Br Med J 338:b1458. https://doi.org/10.1136/bmj.b1458

    Article  Google Scholar 

  9. Ramstad K, Jahnsen R, Skjeldal OH, Diseth TH (2012) Parent-reported participation in children with cerebral palsy: the contribution of recurrent musculoskeletal pain and child mental health problems. Dev Med Child Neurol 54:829–835. https://doi.org/10.1111/j.1469-8749.2012.04341.x

    Article  PubMed  Google Scholar 

  10. Majnemer A, Shevell M, Law M, Birnbaum R, Chilingaryan G, Rosenbaum P, Poulin C (2008) Participation and enjoyment of leisure activities in school-aged children with cerebral palsy. Dev Med Child Neurol 50:751–758. https://doi.org/10.1111/j.1469-8749.2008.03068.x

    Article  PubMed  Google Scholar 

  11. Goldstein M (2004) The treatment of cerebral palsy: what we know, what we don’t know. J Pediatr 145(2):S42–S46. https://doi.org/10.1016/j.jpeds.2004.05.022

    Article  PubMed  Google Scholar 

  12. Trivedi R, Gupta RK, Shah V, Tripathi M, Rathore RK, Kumar M, Narayana PA (2008) Treatment-induced plasticity in cerebral palsy: a diffusion tensor imaging study. Pediatr Neurol 39(5):341–349. https://doi.org/10.1016/j.pediatrneurol.2008.07.012

    Article  PubMed  Google Scholar 

  13. Englander ZA, Sun J, Case L, Mikati MA, Kurtzberg J, Song AW (2015) Brain structural connectivity increases concurrent with functional improvement: evidence from diffusion tensor MRI in children with cerebral palsy during therapy. NeuroImage Clin 7:315–324. https://doi.org/10.1016/j.nicl.2015.01.002

    Article  PubMed  PubMed Central  Google Scholar 

  14. Johnston MV (2009) Plasticity in the developing brain: implications for rehabilitation. Dev Disabil Res Rev 15(2):94–101. https://doi.org/10.1002/ddrr.64

    Article  PubMed  Google Scholar 

  15. Chen R, Cohen LG, Hallett M (2002) Nervous system reorganization following injury. Neuroscience 111(4):761–773. https://doi.org/10.1016/S0306-4522(02)00025-8

    Article  CAS  PubMed  Google Scholar 

  16. Martin JH, Friel KM, Salimi I, Chakrabarty S (2007) Activity-and use-dependent plasticity of the developing corticospinal system. Neurosci Biobehav Rev 31(8):1125–1135. https://doi.org/10.1016/j.neubiorev.2007.04.017

    Article  PubMed  PubMed Central  Google Scholar 

  17. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B (1997) Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 39(4):214–223. https://doi.org/10.1111/j.1469-8749.1997.tb07414.x

    Article  CAS  PubMed  Google Scholar 

  18. Graham HK, Harvey A, Rodda J, Nattrass GR, Pirpiris M (2004) The functional mobility scale (FMS). J Pediatr Orthop 24(5):514–520. https://journals.lww.com/pedorthopaedics/Abstract/2004/09000/The_Functional_Mobility_Scale__FMS_.11.aspx. Accessed 1 Nov 2018

    Article  Google Scholar 

  19. Harvey A, Graham HK, Morris ME, Baker R, Wolfe R (2007) The functional mobility scale: ability to detect change following single event multilevel surgery. Dev Med Child Neurol 49(8):603–607. https://doi.org/10.1111/j.1469-8749.2007.00603.x

    Article  PubMed  Google Scholar 

  20. Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ (2000) Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther 80(9):873–885. https://doi.org/10.1093/ptj/80.9.873

    Article  CAS  PubMed  Google Scholar 

  21. Ko J, Kim M (2013) Reliability and responsiveness of the gross motor function measure-88 in children with cerebral palsy. Phys Ther 93(3):393–400. https://doi.org/10.2522/ptj.20110374

    Article  PubMed  Google Scholar 

  22. Collin C, Wade DT, Davies S, Horne V (1988) The Barthel ADL Index: a reliability study. Int Disabil Stud 10(2):61–63. https://doi.org/10.3109/09638288809164103

    Article  CAS  PubMed  Google Scholar 

  23. Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel Index: a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Md State Med J 14:61–65. https://psycnet.apa.org/record/2012-30334-001. Accessed 1 Nov 2018

    CAS  PubMed  Google Scholar 

  24. Wade DT, Collin C (1988) The Barthel ADL Index: a standard measure of physical disability? Int Disabil Stud 10(2):64–67. https://doi.org/10.3109/09638288809164105

    Article  CAS  PubMed  Google Scholar 

  25. Shah S, Vanclay F, Cooper B (1989) Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 42(8):703–709. https://doi.org/10.1016/0895-4356(89)90065-6

    Article  CAS  PubMed  Google Scholar 

  26. Daltroy LH, Liang MH, Fossel AH, Goldberg MJ (1998) The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. J Pediatr Orthop 18(5):561–571. https://journals.lww.com/pedorthopaedics/Abstract/1998/09000/The_POSNA_Pediatric_Musculoskeletal_Functional.1.aspx. Accessed 1 Nov 2018

    Article  CAS  Google Scholar 

  27. Dilbay NK, Günel MK, Aktan T (2013) Reliability and validity of Turkish version of pediatric outcome data collection instrument (PODCI) for people with cerebral palsy. Fiz Rehabil 24:118–126

    Google Scholar 

  28. Mutlu A, Büğüsan S, Kara ÖK (2017) Impairments, activity limitations, and participation restrictions of the international classification of functioning, disability, and health model in children with ambulatory cerebral palsy. Saudi Med J 38(2):176–185. https://doi.org/10.15537/smj.2017.2.16079

    Article  PubMed  PubMed Central  Google Scholar 

  29. Sullivan E, Barnes D, Linton JL, Calmes J, Damiano D, Oeffinger D, Rogers S (2007) Relationships among functional outcome measures used for assessing children with ambulatory CP. Dev Med Child Neurol 49(5):338–344. https://doi.org/10.1111/j.1469-8749.2007.00338.x

    Article  PubMed  Google Scholar 

  30. Berry JO, Jones WH (1995) The parental stress scale: initial psychometric evidence. J Soc Pers Relat 12(3):463–472. https://doi.org/10.1177/0265407595123009

    Article  Google Scholar 

  31. Zelman JJ, Ferro MA (2018) The parental stress scale: psychometric properties in families of children with chronic health conditions. Fam Relat 67(2):240–252. https://doi.org/10.1111/fare.12306

    Article  Google Scholar 

  32. Kelsey JL, Whittemore AS, Evans AS, Thompson WD (1996) Methods in observational epidemiology (vol 26). Monographs in epidemiology and biostatistics, 2nd edn. Oxford University Press, New York

  33. Tan SS, van der Slot WM, Ketelaar M, Becher JG, Dallmeijer AJ, Smits DW, Perrin+ study group (2016) Factors contributing to the longitudinal development of social participation in individuals with cerebral palsy. Res Dev Disabil 57:125–135. https://doi.org/10.1016/j.ridd.2016.03.015

    Article  PubMed  Google Scholar 

  34. Imms C, Reilly S, Carlin J, Dodd K (2008) Diversity of participation in children with cerebral palsy. Dev Med Child Neurol 50(5):363–369. https://doi.org/10.1111/j.1469-8749.2008.02051.x

    Article  PubMed  Google Scholar 

  35. Smits DW, Ketelaar M, Gorter JW, van Schie P, Dallmeijer A, Jongmans M, Lindeman E (2011) Development of daily activities in school-age children with cerebral palsy. Res Dev Disabil 32(1):222–234. https://doi.org/10.1016/j.ridd.2010.09.025

    Article  PubMed  Google Scholar 

  36. Schenker R, Coster WJ, Parush S (2005) Neuroimpairments, activity performance, and participation in children with cerebral palsy mainstreamed in elementary schools. Dev Med Child Neurol 47(12):808–814. https://doi.org/10.1017/S0012162205001714

    Article  PubMed  Google Scholar 

  37. Harvey A, Baker R, Morris ME, Hough J, Hughes M, Graham HK (2010) Does parent report measure performance? A study of the construct validity of the functional mobility scale. Dev Med Child Neurol 52(2):181–185. https://doi.org/10.1111/j.1469-8749.2009.03354.x

    Article  PubMed  Google Scholar 

  38. Østensjø S, Carlberg EB, Vøllestad NK (2005) The use and impact of assistive devices and other environmental modifications on everyday activities and care in young children with cerebral palsy. Disabil Rehabil 27(14):849–861. https://doi.org/10.1080/09638280400018619

    Article  PubMed  Google Scholar 

  39. Cousino MK, Hazen RA (2013) Parenting stress among caregivers of children with chronic illness: a systematic review. J Pediatr Psychol 38:809–828. https://doi.org/10.1093/jpepsy/jst049

    Article  PubMed  Google Scholar 

  40. Wang HY, Jong YJ (2004) Parental stress and related factors in parents of children with cerebral palsy. Kaohsiung J Med Sci 20(7):334–340. https://doi.org/10.1016/S1607-551X(09)70167-6

    Article  Google Scholar 

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Authors and Affiliations

  1. Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100, Altındağ, Ankara, Turkey

    İpek Alemdaroğlu-Gürbüz

  2. Şefkatevi Private Education and Rehabilitation Center, Esenler, İstanbul, Turkey

    Arzu Burcu Karakuş

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  1. İpek Alemdaroğlu-Gürbüz
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Correspondence to İpek Alemdaroğlu-Gürbüz.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Bezmialem Vakıf University, Clinical Researches Ethical Committee, protocol number 10788) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Alemdaroğlu-Gürbüz, İ., Karakuş, A.B. Examining mobility, independence, motor function, participation, and parental stress in a school-aged Turkish cerebral palsy population: a cross-sectional study. Neurol Sci 40, 2493–2500 (2019). https://doi.org/10.1007/s10072-019-03994-1

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