title: Better walking performance in older children with cerebral palsy.
abstract: BACKGROUND
  Children with cerebral palsy (CP) often walk with a slower speed and a higher energy cost. Their walking performance and choice of mobility method may vary in different environments. Independent mobility is important for activity and participation.
  
  
  OBJECTIVE
  We described walking performance at different distances and environments in relation to gross motor function, CP subtype, and age.
  
  
  METHODS
  We performed a cross-sectional study including all 562 children 3 to 18 years with CP living in southern Sweden during 2008. Data were extracted from a Swedish CP register and healthcare program. The Functional Mobility Scale (FMS) was used for rating mobility at home (5 m), at school (50 m), and in the community (500 m). The FMS scores were analyzed in relation to Gross Motor Function Classification System (GMFCS) level, CP subtype, and age.
  
  
  RESULTS
  In this population, 57% to 63% walked 5 to 500 m without walking aids and 4% to 8% used walking aids. We found a correlation between FMS and GMFCS. The walking performance varied between the subtypes from 96% to 98% in those with spastic unilateral CP to 16% to 24% in children with dyskinetic CP. An increased proportion of children walked independently on all surfaces in each successive age group.
  
  
  CONCLUSIONS
  The overall walking performance increased up to 7 years of age, but the proportion of children walking independently on uneven surfaces was incrementally higher in each age group up to 18 years. The ability to walk on uneven surfaces is important for achieving independent walking in the community.
authors: Department of Orthopaedics, Lund University, University Hospital, 221 85 Lund, Sweden. elisabet.rodby_bousquet@med.lu.se
authors: Elisabet
authors: E
authors: Rodby-Bousquet
authors: Gunnar
authors: G
authors: Hägglund
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000367:Age Factors; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology; D016138:Walking