Predictors of Gross Motor Function Level in Spastic Type Cerebral Palsy: A Retrospective Study

Year 2024, Volume: 35 Issue: 3, 281 - 289, 23.12.2024

Seda Ayaz Taş , Seda Yakıt Yeşilyurt , Tansu Birinci Olgun , Ayşegül Danış

https://doi.org/10.21653/tjpr.1443503

Abstract

Purpose: This study aimed to identify the predictors of gross motor function in spastic-type Cerebral Palsy (CP) over two years.
Methods: 108 children with spastic-type CP (mean age: 6.43±4.83 years) underwent two assessments over two years. The outcomes were the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). Binary logistic regression analysis was used to determine whether factors such as age, sex, topographical distribution, and levels of GMFCS, MACS, CFCS, and EDACS could predict the improvement in GMFCS level after two years of physiotherapy.
Results: Compared to the children with CFCS Level I, children with CFCS Level II, Level III, and Level IV were 0.001, 0.005, and 0.006 times less likely to improve in GMFCS level, respectively. Similarly, children with EDACS Level III and Level IV were respectively 1.605 and 1.548 times less likely to improve in GMFCS level compared to those with Level I. Those with EDACS levels IV and V remained stable for two years in all age groups.
Conclusion: CFCS and EDACS were significant predictors of gross motor function level in spastic-type CP. Healthcare professionals can use CFCS and EDACS to predict the progression of gross motor function levels, thereby providing more appropriate interventions and more realistic predictions.

Keywords

Cerebral Palsy, Classification Systems, Gross Motor Function, Prediction, Prognosis

Spastik Tip Serebral Palside Kaba Motor Fonksiyon Düzeyinin Belirleyicileri: Retrospektif Bir Çalışma

Abstract

Amaç: Bu çalışma, iki yıl boyunca spastik tip Serebral Palsi'de (SP) kaba motor fonksiyonun belirleyicilerini belirlemeyi amaçladı.
Yöntem: Spastik tip SP'li 108 çocuk (ortalama yaş: 6,43±4,83 yıl) iki yıl boyunca iki kez değerlendirildi. Sonuç ölçütleri; Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS), El Becerisi Sınıflandırma Sistemi (EBSS), İletişim Fonksiyon Sınıflandırma Sistemi (İFSS) ve Yeme ve İçme Becerisi Sınıflandırma Sistemi (YİBSS) idi. Yaş, cinsiyet, topografik dağılım ve KMFSS, EBSS, İFSS ve YİBSS düzeyleri gibi faktörlerin iki yıllık fizyoterapiden sonra KMFSS düzeyindeki iyileşmeyi tahmin edip edemeyeceğini belirlemek için ikili lojistik regresyon analizi kullanıldı.
Sonuçlar: İFSS Seviye I olan çocuklarla karşılaştırıldığında, İFSS Seviye II, Seviye III ve Seviye IV olan çocukların KMFSS seviyesinde iyileşme olasılığı sırasıyla 0,001, 0,005 ve 0,006 kat daha azdı. Benzer şekilde, YİBSS Seviye III ve Seviye IV olan çocukların KMFSS seviyesinde iyileşme olasılığı Seviye I olanlara göre sırasıyla 1.605 ve 1.548 kat daha azdı. YİBSS Düzey IV ve V olanlar tüm yaş gruplarında iki yıl boyunca stabil kaldı.
Tartışma: İFSS ve YİBSS, spastik tip SP'de kaba motor fonksiyon seviyesinin anlamlı belirleyicileriydi. Sağlık uzmanları, kaba motor fonksiyon seviyelerinin ilerleyişini tahmin etmek için İFSS ve YİBSS’yi kullanabilir, böylece daha uygun müdahaleler ve daha gerçekçi tahminler sağlayabilir.

Keywords

Serebral Palsi, Sınıflandırma Sistemleri, Kaba Motor Fonksiyon, Öngörü, Prognoz

References

• Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr Dis Treat. 2020; 16:1505-18.
• Gulati S, Sondhi V. Cerebral palsy: an overview. Indian J Pediatr. 2018; 85:1006-16.
• Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr. 2020;9(Suppl 1): S125-35.
• Paul S, Nahar A, Bhagawati M, Kunwar AJ. A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022; 2022:2622310.
• Park EY. Stability of the gross motor function classification system in children with cerebral palsy for two years. BMC Neurol. 2020;20(1):172.
• Palisano RJ, Avery L, Gorter JW, Galuppi B, McCoy SW. Stability of the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System. Dev Med Child Neurol. 2018;60(10):1026-32.
• Tschirren L, Bauer S, Hanser C, Marsico P, Sellers D, Hubertus VHJA. The Eating and Drinking Ability Classification System: concurrent validity and reliability in children with cerebral palsy. Dev Med Child Neurol. 2018;60(6):611–7.
• Rosenbaum P, Walter S, Hanna S, Palisano R, Russell DJ, Raina P. et al. Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA. 2002;288(11):1357–63.
• Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy. Children (Basel). 2017;4(4):30.
• Bottos M, Gericke C. Ambulatory capacity in cerebral palsy: prognostic criteria and consequences for intervention. Dev Med Child Neurol. 2003;45(11):786-90.
• Park EY. Stability of the Communication Function Classification System among children with cerebral palsy in South Korea. Int J Environ Res Public Health. 2021;18(4):1881.
• Burgess A, Boyd R, Ziviani J, Chatfield MD, Ware RS, Sakzewski L. Stability of the Manual Ability Classification System in young children with cerebral palsy. Dev Med Child Neurol. 2019;61(7):798-804.
• Yenipınar A, Koç Ş, Çanga D, Kaya F. Determining sample size in logistic regression with G-Power. BSJ Eng Sci. 2019;2(1), 16-22.
• Verma JP, Verma P. Use of G* power software. Determining Sample Size and Power in Research Studies: A Manual for Researchers. Springer, Singapore; 2020: p. 55-60.
• Montero Mendoza S, Calvo Munoz I. Analysis of relationship among the functional classification systems in cerebral palsy and the different types according to the Surveillance of Cerebral Palsy in Europe. Pediatr Dimens. 2019; 4:1-5.
• El Ö, Baydar M, Berk H, Peker Ö, Koşşay C, Demiral Y. Interobserver reliability of the Turkish version of the expanded and revised gross motor function classification system. Disabil Rehabil. 2012;34(12):1030–3.
• Eliasson AC, Ullenhag A, Wahlström U, Krumlinde-Sundholm L. Mini‐MACS: development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy. Dev Med Child Neurol. 2016;59(1):72–8.
• Akpinar P, Tezel CG, Eliasson AC, Icagasioglu A. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabil. 2010;32(23):1910–6.
• Mutlu A, Kara Ö, Livanelioğlu A, Karahan S, Alkan H, Yardımcı BN, et al. Agreement between parents and clinicians on the communication function levels and relationship of classification systems of children with cerebral palsy. Disabil Health J. 2018;11(2):281–6.
• Tschirren L, Bauer S, Hanser C, Marsico P, Sellers D, Hubertus VHJA. The Eating and Drinking Ability Classification System: concurrent validity and reliability in children with cerebral palsy. Dev Med Child Neurol. 2018;60(6), 611–7.
• Günel M, Özal C, Seyhan K, Arslan S, Demir N, Karaduman A. Yeme ve İçme Becerileri Sınıflandırma Sisteminin Türkçe Versiyonu: Serebral Palsili Çocuklarda Değerlendirici-İçi Güvenirliği. Turk J Physiother Rehabil. 2020;31(3):218–24.
• Unes S, Tuncdemir M, Ozal C, Cankaya O, Seyhan Biyik K, Delioglu K, et al. Relationship among four functional classification systems and parent interpredicted intelligence level in children with different clinical types of cerebral palsy. Dev Neurorehabil. 2022;25(6):410–6.
• Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy. Children. 2017;4(30):1–10.
• Hidecker MJ, Ho NT, Dodge N, Hurvitz EA, Slaughter J, Workinger MS, Kent RD, Rosenbaum P, Lenski M, Messaros BM, Vanderbeek SB, Deroos S, Paneth N. Inter-relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children. Dev Med Child Neurol. 2012;54(8):737-42.
• Hidecker MJ, Paneth N, Rosenbaum PL, Kent RD, Lillie J, Eulenberg JB, Chester K Jr, Johnson B, Michalsen L, Evatt M, Taylor K. Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Dev Med Child Neurol. 2011;53(8):704-10.
• Sellers D, Bryant E, Hunter A, Campbell V, Morris C. The eating and drinking ability classification system for cerebral palsy: A study of reliability and stability over time. J Pediatr Rehabil Med. 2019;12(2):123–31.
• McCormick A, Brien M, Plourde J, Wood E, Rosenbaum P, McLean J. Stability of the Gross Motor Function Classification System in adults with cerebral palsy. Dev Med Child Neurol. 2007;49(4):265–9.
• Keeratisiroj O, Thawinchai N, Siritaratiwat W, Buntragulpoontawee M, Pratoomsoot C. Prognostic predictors for ambulation in children with cerebral palsy: a systematic review and meta-analysis of observational studies. Disabil Rehabil. 2016;40(2):135–43.
• Wu Y, Day S, Strauss D, Shavelle R. Prognosis for ambulation in cerebral palsy: a population-based study. Pediatrics. 2004;114(5):1264–71.
• Alriksson-Schmidt A, Nordmark E, Czuba T, Westbom L. Stability of the Gross Motor Function Classification System in children and adolescents with cerebral palsy: a retrospective cohort registry study. Dev Med Child Neurol. 2017;59(6):641–6.
• Sellers D, Bryant E, Hunter A, Campbell V, Morris C. The eating and drinking ability classification system for cerebral palsy: A study of reliability and stability over time. J Pediatr Rehabil Med. 2019;12(2):123–31.
• Alriksson-Schmidt A, Nordmark E, Czuba T, Westbom L. Stability of the Gross Motor Function Classification System in children and adolescents with cerebral palsy: a retrospective cohort registry study. Dev Med Child Neurol. 2017;59(6):641–6.