Motor impairments and activity limitations in children with spastic cerebral palsy: a Dutch population-based study.
OBJECTIVE
To determine the prevalence of motor impairments and activity limitations and their inter-relationships in Dutch children with spastic cerebral palsy.


METHODS
In a population-based survey 119 children, age range 6-19 years, with spastic cerebral palsy were examined. Anthropometry, muscle tone, abnormal posture, joint range of motion, major orthopaedic impairments and gross motor functioning and manual ability were assessed or classified, in addition to limitations in mobility and self-care activities. Spearman's correlation coefficients, bivariate post hoc analyses and univariate and multivariate logistic regression analyses were used.


RESULTS
Children with spastic cerebral palsy had a lower body height and weight compared with typically developing peers. Forty percent had no range of motion deficits. Hip dislocations were rarely encountered. Motor impairments were associated with gross motor functioning and manual ability levels. Close to sixty-five percent walked independently. Children with diplegia and tetraplegia differed in activity limitations. Motor impairments and limitations in mobility and self-care activities were only modestly related in multivariate analyses.


CONCLUSIONS
Distribution of cerebral palsy-related characteristics is consistent with that found in representative studies of other countries. The distinction between diplegia and tetraplegia is relevant from an activity point of view. The child's activity limitations are not a mirror of the motor impairments, which suggests multifactorial influences. An activity-oriented rehabilitation approach goes beyond treating specific impairments.
Deptartment of Rehabilitation Medicine, Erasmus MC-University Medical Centre Rotterdam, PO Box 2040, NL-3000 CA Rotterdam, The Netherlands. mjwichers@gmail.com
Marc
M
Wichers
Sander
S
Hilberink
Marij E
ME
Roebroeck
Onno
O
van Nieuwenhuizen
Henk J
HJ
Stam
D000203:Activities of Daily Living; D000293:Adolescent; D001827:Body Height; D001835:Body Weight; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009068:Movement / Q000502:physiology; D009129:Muscle Tonus / Q000502:physiology; D011187:Posture / Q000502:physiology; D011782:Quadriplegia / Q000503:physiopathology / Q000534:rehabilitation; D016059:Range of Motion, Articular; D055815:Young Adult