title: Correlations between risk factors and functional evolution in patients with spastic quadriplegia.
abstract: Cerebral palsy is the most common cause of developing neuro-motor disability in children, in many cases, the triggering cause remaining unknown. Quadriplegia is the most severe spastic cerebral palsy, characterized by severe mental retardation and bi-pyramidal syndrome. The purpose of this paper was to demonstrate the importance of knowing the risk factors and the psychosomatic ones, determining to what extent they influence the functional evolution in patients diagnosed with spastic quadriplegia. 23 children diagnosed with spastic quadriplegia were included in the study, being aged between 1 year and half and 12 years. Patients were assessed at baseline (T1), at one year (T2) and after two years at the end of the study (T3). Patients received a comprehensive rehabilitation program for the motor and sensory deficits throughout the study. Initially, a comprehensive evaluation (etiopathogenic, clinical and functional) that started from a thorough medical history of children (the older ones), was conducted but chose parents to identify the risk factors, and a complete physical exam. At each assessment, joint and muscle balance was conducted. To assess functionality, the gross motor function classification systems (GMFCS) and manual ability (MACS) were used. Many risk factors that were classified according to the timeline in prenatal factors, perinatal and postnatal, were identified from a thorough history. A direct correlation was noticed between the decrease of coarse functionality and manual ability, both initially and in dynamic and low APGAR scores, low gestational age, low birth weight and a higher body mass index of the mother. A direct link was observed between the gross motor function and the manual ability. A significant improvement in the MACS score was noticed in patients with a better GMFCS score.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: O C
authors.initials: OC
authors.lastname: Rogoveanu
authors.affiliation: Faculty of Nursing and Midwives, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: N C
authors.initials: NC
authors.lastname: Tuțescu
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: D
authors.initials: D
authors.lastname: Kamal
authors.affiliation: Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: D O
authors.initials: DO
authors.lastname: Alexandru
authors.affiliation: Department of Family Medicine, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Kamal
authors.affiliation: Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: L
authors.initials: L
authors.lastname: Streba
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania.
authors.forename: M R
authors.initials: MR
authors.lastname: Trăistaru
mesh_terms: D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D007223:Infant; D008297:Male; D008423:Maternal Age; D009048:Motor Skills; D011782:Quadriplegia / Q000453:epidemiology* / Q000503:physiopathology*; D012307:Risk Factors
keywords: GMFCS; MACS; risk factors; spastic quadriplegia