Lower Extremity Evaluation in Children With Diparetic Cerebral Palsy According to ICF Perspective

Cerebral palsy (CP); is the most common neurodevelopmental disorder seen in childhood, characterized by permanent motor dysfunctions that develop due to brain damage occurring before birth, during birth, or in early childhood.

The most common type is spastic type CP with a prevalence rate of 70-80%. Spastic type CP is divided into three groups as diparetic (38%), hemiparetic (39%) and quadriparetic (23%). In diparetic cerebral palsy (DCP); lower extremity involvement is more pronounced than upper extremity involvement. Typically; weakness in the trunk, postural and antigravity muscles, functional and/or structural asymmetry between both lower extremities are seen and this condition is closely related to impaired static and/or dynamic balance, decreased postural control, decreased functional performance, and low participation rate in activities.

The ICF (International Classification of Functioning, Disability, and Health) was developed by the World Health Organization in 2001 and is a comprehensive model that evaluates health status not only through the presence of diseases and disorders but also through various dimensions such as functionality, environmental, and personal factors. The ICF model includes five main components to evaluate an individual's functionality and disability: body structure and functions, activity, participation, environmental and personal factors. In recent years, functional abilities, including social participation, have increasingly become the focus of research in children with CP.

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Key information

Conditions

Diparesis Behavior Brain Damage, Chronic Brain Diseases Central Nervous System Diseases Cerebral Palsy Diplegic Cerebral Palsy Lower Extremity Paresis Motor Activity Nervous System Diseases Neurologic Manifestations Paresis Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

3 year–13 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Acıbadem Altunizade Hospital

Istanbul, Turkey (Türkiye)

About this study

It's an observational study.

Purpose of the study: The increase in tone seen in the lower extremities in children with diparetic cerebral palsy (DCP) may adversely affect the activity and participation of children. Our study aim is to evaluate lower extremities in children with DCP according to ICF perspective.

A total of 30 cases, 15 females (50%) and 15 males (50%), aged between 3 and 13 years (mean: 5.8), who were admitted to the Pediatric Rehabilitation Department of Acıbadem Altunizade Hospital with the diagnosis of DCP between 2019 and 2022, were included in this cross-sectional study.

What should the rehabilitation program for children with DCP include?
What should we consider when evaluating children with DCP?

The lower extremity evaluations of these cases were made according to ICF. Modified Ashworth Scale (MAS) was used for body structure and functions, Gillette Functional Assessment Questionnaire (FAQ) was used for activity, and Pediatric Functional Independence Measure (WeeFIM) was used for participation

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Between 3-13 years old,
Diagnosis of diparetic cerebral palsy,
Participants and/or parents willing to participate in the study voluntarily.

Exclusion criteria

Having different types of CP such as dyskinetic, mixed, ataxic types other than spastic type,
Having spastic quadriparetic or hemiparetic type CP,
Having received Botulinum Toxin injections to the lower extremities within the last 6 months.

Treatment and study plan

Group1

Other

30 children with DCP were included. The lower extremity evaluations of these cases were made according to ICF. Modified Ashworth Scale (MAS) was used for body structure and functions, Gillette Functional Assessment Questionnaire (FAQ) was used for activity and Pediatric Functional Independence Measure (WeeFIM) was used for participation.

Primary outcomes

Modified Ashworth Scale (MAS)

Time frame: baseline

It is a 6-point scale used to describe the resistance of the muscle to passive movement and the ease with which the joint can be moved within the available range. It is frequently used in clinical settings. It is quite practical to evaluate and interpret.
Gillette Functional Walking Assessment Questionnaire (FAQ)

Time frame: baseline

It is a measurement tool used to evaluate walking ability and functional mobility in children. This questionnaire was developed specifically to evaluate the walking functions of children with cerebral palsy and other neuromuscular disorders. Developed at Gillette Children's Hospital, this questionnaire aims to rate children's walking abilities in different environments. It scores children's walking skills on a scale of 1-10.
Pediatric Functional Independence Scale (WeeFIM)

Time frame: baseline

The WeeFIM scale is a tool used to assess children's independence levels and functional abilities. It was developed to objectively assess children's independence levels and whether they need assistance with daily living activities. The scale consists of 6 main headings and 18 subheadings. These subheadings evaluate areas such as self-care (feeding, dressing, toilet use), sphincter control, transfers (e.g. bed, chair), movement (walking, wheelchair use), communication and social cognition (problem solving, memory). Scoring ranges from 1 to 7, with the highest score being 126. As the score increases, assistance decreases and independence increases.

Sponsors and collaborators

Lead sponsor

Acıbadem Atunizade Hospital

Other

Registry information

Important dates

Study start: 2002
Primary completion: 2022
Study completion: 2022
First posted: Sep 4, 2024
Registry last updated: Sep 4, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed