Correlation of Siting and Standing Performance with Gross Motor Functional Classification System in Children with Spastic Cerebral Palsy
DOI:
https://doi.org/10.61919/jhrr.v4i1.340Keywords:
cerebral palsy, GMFCS, sitting and standing performance, spastic cerebral palsy, child mobilityAbstract
Background: Cerebral palsy (CP) is the most common motor disability in childhood, with spasticity as a frequent complication. Understanding the relationship between the Gross Motor Function Classification System (GMFCS) and motor abilities, such as sitting and standing performance, is critical for managing CP.
Objective: This study aimed to analyze the correlation between sitting and standing performance with GMFCS in children with spastic cerebral palsy.
Methods: A cross-sectional study was conducted with 350 children diagnosed with CP, aged 6-12 years. Data were gathered over six months at a government secondary school for special education. The GMFCS was used to classify motor function, while sitting and standing abilities were assessed using the Sit to Stand Test. Data analysis was performed using SPSS version 25, employing descriptive statistics and Spearman's rank correlation.
Results: The study found that children at GMFCS levels I and II could often sit and walk with minimal or no assistance, whereas those at levels IV and V exhibited varied sitting abilities and primarily used technological aids or wheelchairs. A statistically significant association between sitting ability and GMFCS level was identified (Pearson Chi-Square = 29.151, p = 0.023). Children with spastic CP were predominantly classified at GMFCS levels III (49 participants) and V (49 participants), while those with dyskinetic CP were mainly at level II (13 participants).
Conclusion: The GMFCS is an effective tool for assessing gross motor function in children with CP, with strong correlations found between GMFCS levels and sitting and standing performance. These findings can inform targeted interventions to improve mobility and quality of life for children with CP.
Downloads
References
Hegazy RG, Abdel-aziem AA, El Hadidy EI, Ali YM. Effects of whole-body vibration on quadriceps and hamstring muscle strength, endurance, and power in children with hemiparetic cerebral palsy: a randomized controlled study. Bulletin of Faculty of Physical Therapy. 2021;26(1):6.
Afzal M, Zamir Rasib K. Termite diversity and damage assessment in urban trees from different parks of Lahore, Punjab, Pakistan. Environmental science and pollution research international. 2022.
Wilkins SS, Melrose RJ, Hall KS, Blanchard E, Castle SC, Kopp T, et al. PTSD Improvement Associated with Social Connectedness in Gerofit Veterans Exercise Program. Journal of the American Geriatrics Society. 2021;69(4):1045-50.
Nelson KB, Ellenberg JH. Children who ‘outgrew’cerebral palsy. Pediatrics. 1982;69(5):529-36.
Dandawate P, Ghosh C, Palaniyandi K, Paul S, Rawal S, Pradhan R, et al. The Histone Demethylase KDM3A, Increased in Human Pancreatic Tumors, Regulates Expression of DCLK1 and Promotes Tumorigenesis in Mice. Gastroenterology. 2019;157(6):1646-59.e11.
McIntyre S, Morgan C, Walker K, Novak I. Cerebral palsy—don't delay. Developmental disabilities research reviews. 2011;17(2):114-29.
Iwase H, Murata S, Nakano H, Shiraiwa K, Abiko T, Goda A, et al. Relationship Between Age-Related Changes in Skeletal Muscle Mass and Physical Function: A Cross-Sectional Study of an Elderly Japanese Population. Cureus. 2022;14(4):e24260.
De B, Ng SP, Liu AY, Avila S, Tao R, Holliday EB, et al. Radiation-Associated Lymphopenia and Outcomes of Patients with Unresectable Hepatocellular Carcinoma Treated with Radiotherapy. Journal of hepatocellular carcinoma. 2021;8:57-69.
Hidecker MJC, Paneth N, Rosenbaum PL, Kent RD, Lillie J, Eulenberg JB, et al. Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Developmental Medicine & Child Neurology. 2011;53(8):704-10.
MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. American journal of obstetrics and gynecology. 2015;213(6):779-88.
MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. American journal of obstetrics and gynecology. 2015;213(6):779-88.
Wang L, Yang Y, Yin P, Ren Z, Liu W, Tian Z, et al. MoO(x)-Decorated Co-Based Catalysts toward the Hydrodeoxygenation Reaction of Biomass-Derived Platform Molecules. ACS applied materials & interfaces. 2021;13(27):31799-807.
Aisen ML, Kerkovich D, Mast J, Mulroy S, Wren TA, Kay RM, et al. Cerebral palsy: clinical care and neurological rehabilitation. The Lancet Neurology. 2011;10(9):844-52.
Nashner LM, Shumway-Cook A, Marin O. Stance posture control in select groups of children with cerebral palsy: deficits in sensory organization and muscular coordination. Experimental brain research. 1983;49(3):393-409.
Hicks JL, Schwartz MH, Arnold AS, Delp SL. Crouched postures reduce the capacity of muscles to extend the hip and knee during the single-limb stance phase of gait. Journal of biomechanics. 2008;41(5):960-7.
Lau CS, Lim M, Hoo SP, Gan C, Aw TC. Faster HbA1c Turnaround Times Using a Dedicated Analyzer Based on Turbidimetric Inhibition Immunoassay Technology. The journal of applied laboratory medicine. 2021;6(3):729-34.
Myhr U, von Wendt L, Norrlin S, Radell U. Five-year follow-up of functional sitting position in children with cerebral palsy. Developmental medicine and child neurology. 1995;37(7):587-96.
Saquetto M, Carvalho V, Silva C, Conceição C, Gomes-Neto M. The effects of whole body vibration on mobility and balance in children with cerebral palsy: a systematic review with meta-analysis. Journal of musculoskeletal & neuronal interactions. 2015;15(2):137-44.
Sala DA, Grant AD. Prognosis for ambulation in cerebral palsy. Developmental medicine and child neurology. 1995;37(11):1020-6.
Pavão SL, Lima CRG, Rocha NACF. Association between sensory processing and activity performance in children with cerebral palsy levels I-II on the gross motor function classification system. Brazilian Journal of Physical Therapy. 2021;25(2):194-202.
Piscitelli D, Ferrarello F, Ugolini A, Verola S, Pellicciari L. Measurement properties of the Gross Motor Function Classification System, Gross Motor Function Classification System-Expanded & Revised, Manual Ability Classification System, and Communication Function Classification System in cerebral palsy: a systematic review with meta-analysis. Developmental Medicine & Child Neurology. 2021;63(11):1251-61.
Monica S, Nayak A, Joshua AM, Mithra P, Amaravadi SK, Misri Z, et al. Relationship between Trunk Position Sense and Trunk Control in Children with Spastic Cerebral Palsy: A Cross-Sectional Study. Rehabilitation Research and Practice. 2021;2021:9758640.
Rosdiana I, Ariestiani A. The Correlation between Gross Motor Function Classification System and Spasticity in Children with Cerebral Palsy. Journal of Advanced Multidisciplinary Research. 2021;2(2):70-7.
Gerber CN, Carcreff L, Paraschiv-Ionescu A, Armand S, Newman CJ. Multidimensional Measures of Physical Activity and Their Association with Gross Motor Capacity in Children and Adolescents with Cerebral Palsy. Sensors. 2020;20(20):5861.
Clutterbuck GL, Auld ML, Johnston LM. High-level motor skills assessment for ambulant children with cerebral palsy: a systematic review and decision tree. Developmental Medicine & Child Neurology. 2020;62(6):693-9.
Saleh M, Almasri NA, Malkawi SH, Abu-Dahab S. Associations between impairments and activity limitations components of the international classification of functioning and the gross motor function and subtypes of children with cerebral palsy. Journal of Physical Therapy Science. 2019;31(4):299-305.
LaForme Fiss A, McCoy SW, Bartlett D, Avery L, Hanna SE, Team OTS. Developmental Trajectories for the Early Clinical Assessment of Balance by Gross Motor Function Classification System Level for Children With Cerebral Palsy. Physical Therapy. 2019;99(2):217-28.
Yu Y, Chen X, Cao S, Wu D, Zhang X, Chen X. Gait synergetic neuromuscular control in children with cerebral palsy at different gross motor function classification system levels. Journal of Neurophysiology. 2019;121(5):1680-91.
Almasri NA, Saleh M, Abu-Dahab S, Malkawi SH, Nordmark E. Functional profiles of children with cerebral palsy in Jordan based on the association between gross motor function and manual ability. BMC Pediatr. 2018;18(1):276.
Cobanoglu M, Cullu E, Omurlu I. The effect of hip reconstruction on gross motor function levels in children with cerebral palsy. Acta Orthopaedica et Traumatologica Turcica. 2018;52(1):44-8.
Rodby-Bousquet E, Hägglund G. Sitting and standing performance in a total population of children with cerebral palsy: a cross-sectional study. BMC Musculoskeletal Disorders. 2010;11(1):131.
Zarkou A, Lee SC, Prosser LA, Jeka JJ. Foot and ankle somatosensory deficits affect balance and motor function in children with cerebral palsy. Frontiers in Human Neuroscience. 2020;14:45.
Carrasco M. How visual spatial attention alters perception. Cognitive processing. 2018;19(Suppl 1):77-88.
Arshad S, Arora S. Co-Relation between Body Mass Index and Gross Motor Function Classification in Children with Cerebral Palsy. Journal of Medical and Dental Science Research. 2021;8(8):55-8.
Born S, Ansorge U, Kerzel D. Predictability of spatial and non-spatial target properties improves perception in the pre-saccadic interval. Vision research. 2013;91:93-101.
Jung Y, Chung E-J, Chun H-L, Lee B-H. Effects of whole-body vibration combined with action observation on gross motor function, balance, and gait in children with spastic cerebral palsy: a preliminary study. Journal of exercise rehabilitation. 2020;16(3):249.
Chagas PS, Drumond CM, Toledo AM, de Campos AC, Camargos ACR, Longo E, et al. Study protocol: functioning curves and trajectories for children and adolescents with cerebral palsy in Brazil–PartiCipa Brazil. BMC pediatrics. 2020;20(1):1-10.
Chatterjee A, Coburn A, Weinberger A. The neuroaesthetics of architectural spaces. Cognitive processing. 2021;22(Suppl 1):115-20.
Pantzar-Castilla EHS, Wretenberg P, Riad J. Knee flexion contracture impacts functional mobility in children with cerebral palsy with various degree of involvement: a cross-sectional register study of 2,838 individuals. Acta Orthopaedica. 2021;92(4):472-8.
Guillemin C, Tillmann B. Implicit learning of two artificial grammars. Cognitive processing. 2021;22(1):141-50.
Corballis MC. Space, time, and language. Cognitive processing. 2018;19(Suppl 1):89-92.
Hung TW. Nonhuman rationality: a predictive coding perspective. Cognitive processing. 2021;22(2):353-62.
Schmidt SM, Hägglund G, Alriksson‐Schmidt AI. Bone and joint complications and reduced mobility are associated with pain in children with cerebral palsy. Acta Paediatrica. 2020;109(3):541-9.
Yesiltepe D, Conroy Dalton R, Ozbil Torun A. Landmarks in wayfinding: a review of the existing literature. Cognitive processing. 2021;22(3):369-410.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nasrullah Kausar, Muhammad Asad Gul, Rameel Ur Rehman Cheema , Noman Ahmad, Muhammad Ammar, Abdur Rehman
This work is licensed under a Creative Commons Attribution 4.0 International License.