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Physical risk factors influencing wheeled mobility in children with cerebral palsy : A cross-sectional study

Rodby-Bousquet, Elisabet LU ; Paleg, Ginny; Casey, Jackie; Wizert, Alicja and Livingstone, Roslyn (2016) In BMC Pediatrics 16(1).
Abstract

Background: There is a lack of understanding of the factors that influence independent mobility and participation in meaningful activities. The purpose of this study was to analyse physical factors influencing independent use of manual and power wheelchairs in a total population of children with cerebral palsy (CP). Methods: A cross-sectional study based on the most recent examination of all children with CP, born 2002-2013, reported into the Swedish cerebral palsy registry (CPUP), from January 2012 to June 2014. There were 2328 children (58 % boys, 42 % girls), aged 0-11 years, at all levels of gross motor function and hand function. Hazard ratios adjusted for age and sex were used to calculate the risk for not being able to... (More)

Background: There is a lack of understanding of the factors that influence independent mobility and participation in meaningful activities. The purpose of this study was to analyse physical factors influencing independent use of manual and power wheelchairs in a total population of children with cerebral palsy (CP). Methods: A cross-sectional study based on the most recent examination of all children with CP, born 2002-2013, reported into the Swedish cerebral palsy registry (CPUP), from January 2012 to June 2014. There were 2328 children (58 % boys, 42 % girls), aged 0-11 years, at all levels of gross motor function and hand function. Hazard ratios adjusted for age and sex were used to calculate the risk for not being able to self-propel based on Gross Motor Function Classification System (GMFCS) levels, upper extremity range of motion and hand function including Manual Ability Classification System (MACS), House functional classification system, Thumb-in-palm deformity, Zancolli (spasticity of wrist/finger flexors) and bimanual ability. Results: In total 858 children used wheelchairs outdoors (692 manual, 20 power, 146 both). Only 10 % of the 838 children self-propelled manual wheelchairs, while 90 % were pushed. In contrast 75 % of the 166 children who used power mobility outdoors were independent. Poor hand function was the greatest risk factor for being unable to self-propel a manual wheelchair, while classification as GMFCS V or MACS IV-V were the greatest risk factors for not being able to use a power wheelchair independently. Conclusions: The majority of children with CP, aged 0-11 years did not self-propel manual wheelchairs regardless of age, gross motor function, range of motion or manual abilities. Power mobility should be considered at earlier ages to promote independent mobility for all children with CP who require a wheelchair especially outdoors.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, Children, GMFCS, Hand function, MACS, Mobility, Power, Range of motion, Wheelchairs
in
BMC Pediatrics
volume
16
issue
1
publisher
BioMed Central
external identifiers
  • scopus:84990848189
  • wos:000384939500001
ISSN
1471-2431
DOI
10.1186/s12887-016-0707-6
language
English
LU publication?
yes
id
2f1bfbbd-51af-40c3-8917-4c52c90aa292
date added to LUP
2016-11-02 10:01:55
date last changed
2017-08-01 08:19:06
@article{2f1bfbbd-51af-40c3-8917-4c52c90aa292,
  abstract     = {<p>Background: There is a lack of understanding of the factors that influence independent mobility and participation in meaningful activities. The purpose of this study was to analyse physical factors influencing independent use of manual and power wheelchairs in a total population of children with cerebral palsy (CP). Methods: A cross-sectional study based on the most recent examination of all children with CP, born 2002-2013, reported into the Swedish cerebral palsy registry (CPUP), from January 2012 to June 2014. There were 2328 children (58 % boys, 42 % girls), aged 0-11 years, at all levels of gross motor function and hand function. Hazard ratios adjusted for age and sex were used to calculate the risk for not being able to self-propel based on Gross Motor Function Classification System (GMFCS) levels, upper extremity range of motion and hand function including Manual Ability Classification System (MACS), House functional classification system, Thumb-in-palm deformity, Zancolli (spasticity of wrist/finger flexors) and bimanual ability. Results: In total 858 children used wheelchairs outdoors (692 manual, 20 power, 146 both). Only 10 % of the 838 children self-propelled manual wheelchairs, while 90 % were pushed. In contrast 75 % of the 166 children who used power mobility outdoors were independent. Poor hand function was the greatest risk factor for being unable to self-propel a manual wheelchair, while classification as GMFCS V or MACS IV-V were the greatest risk factors for not being able to use a power wheelchair independently. Conclusions: The majority of children with CP, aged 0-11 years did not self-propel manual wheelchairs regardless of age, gross motor function, range of motion or manual abilities. Power mobility should be considered at earlier ages to promote independent mobility for all children with CP who require a wheelchair especially outdoors.</p>},
  articleno    = {165},
  author       = {Rodby-Bousquet, Elisabet and Paleg, Ginny and Casey, Jackie and Wizert, Alicja and Livingstone, Roslyn},
  issn         = {1471-2431},
  keyword      = {Cerebral palsy,Children,GMFCS,Hand function,MACS,Mobility,Power,Range of motion,Wheelchairs},
  language     = {eng},
  month        = {10},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Pediatrics},
  title        = {Physical risk factors influencing wheeled mobility in children with cerebral palsy : A cross-sectional study},
  url          = {http://dx.doi.org/10.1186/s12887-016-0707-6},
  volume       = {16},
  year         = {2016},
}