title: Changes in Capacity and Performance in Mobility Across Different Environmental Settings in Children with Cerebral Palsy: An Exploratory Study.
abstract: BACKGROUND
  Children with cerebral palsy, although having similar diagnosis, varies in their abilities & level of functioning within & across different environmental context e.g. home, school or community setting. Capacity (what a child can do in standardized, controlled environment) may or may not be the same as performance (what a child actually does do in her/her daily environment).
  
  
  METHODS
  After getting approval from Institutional Ethic's Committee (IEC), 63 children with cerebral palsy (4-16 year, mean 7.4 year with SD 0.39) of all clinical types, Gross Motor Functional Classification System (GMFCS) level I-V were examined for mobility using Gross Motor Functional Measure 88 (GMFM). Motor capacity was assessed in clinical setting by highest of 3 GMFM items attained, i.e., crawling (44), walks with support (68) & walks without support (70). Motor performance was measured by Functional Mobility Scale version 2.
  
  
  RESULTS
  On analysis of motor capacity 42.85% children were walking without support, 15.87% were able to crawl & 26.98% were able walk with support in clinical setting. Spearman's Correlation was done between GMFM item 70 with FMS 5 (home setting) to check correlation of capacity with performance & was found to be significantly correlated (r=0.586, p=0.04). All three GMFM items were correlated with FMS 5, 50, 500 & found positively correlated. For community setting (FMS 500), 52.38% children were lifted by parents & only 6.34% were using wheel chair mobility. A total of 21.87% patients were able to walk with or without support & still lifted by parents in school or community setting.
  
  
  CONCLUSIONS
  Change in capacity and performance of mobility exists mainly in school and community setting in studied population. Context should be given importance to prioritize rehabilitation process.
authors.affiliation: Lecturer, Department of Paediatrics Physiotherapy, S.B.B College of Physiotherapy, VS Hospital , Ahmedabad, Gujarat, India .
authors.forename: Shraddha
authors.initials: S
authors.lastname: Diwan
authors.affiliation: Professor & Head, Department of Physiology, GMERS Medical College, Civil Hospital , Gandhinagar, Gujarat, India .
authors.forename: Jasmin
authors.initials: J
authors.lastname: Diwan
authors.affiliation: MPT Neurology, Department of Paediatrics Physiotherapy, S.B.B College of Physiotherapy , Ahmedabad, Gujarat, India .
authors.forename: Ankita B
authors.initials: AB
authors.lastname: Bansal
authors.affiliation: Dean & Professor, Department of Orthopaedics, Smt. NHL Municipal Medical College, V S Hospital , Ahmedabad, Gujarat, India .
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Patel
keywords: Community; ICF; Motor capacity