ABSTRACT
Objective: To assess prevalence of gross and fine motor functional impairments in children with CP
Methods: This cross sectional study was conducted at Department of Developmental and Behavioural Paediatrics, The Children's Hospital and Institute of Child Health, Lahore from October, 2014 to September, 2015. Atotal of 100 CP patients were taken to assess for gross and fine motor functional impairment, using Gross Motor Functional Classification System [GMFCS] and Bimanual Fine Motor Function [BFMF] scales. All data were analyzed using SPSS version 20
Results: In this hospital-based study comprised 100 children with a diagnosis of CP with 2 to 8 years of age were ascertained. The mean age of patients was found as 4.090 +/- 1.672 years. Study group included 32 females and 68 males. GMFCS was found at level I in 5% patients, level II in 18% patients, level III in 16% patients, level IV in 15% patients and level V in 46% patients. The corresponding percentages for BFMF were 21.7% patients, 18% patients, 15% patients, 13% patients and 33% respectively. Among oral musculature problems, drooling was the most common problem [68 %]. Larger proportion of gross motor functional impairment were associated with the spastic type of cerebral palsy [p=0.03], more specifically quadriplegic cerebral palsy [p=0.000]. Also a larger number of patients with fine motor functional impairments were associated with spastic type of cerebral palsy [p=0.009], more precisely quadriplegic cerebral palsy [p=0.000]
Conclusion: It is concluded that quadriplegic spastic CP was the most frequent type that had the worst motor impairment hence making patients functionally dependant in activities of daily livings
ABSTRACT
Cerebral Palsy is a disorder of movement and postural balance due to insult to the brain. The injury to the developing brain may be prenatal, natal or postnatal. The diagnosis is clinical mainly. The spastic Cerebral Palsy is classified into monoplegic, hemiplegic, diplegic, and quadriplegic types. There is a difference in the frequency of these types of Cerebral Palsy in different studies. The patterns of various forms of Cerebral Palsy emerge gradually with a delay in developmental milestones. A spectrum of associated developmental disabilities has been found to be common in these children. Management is through a multi-disciplinary approach. To find out the frequency of different types of Cerebral Palsy and degree of associated developmental delay. A cross sectional study was carried out for a period of six months [October 1, 2006 to March 31, 2007] at The Children's Hospital and Institute of Child Health Lahore. 100 Cases diagnosed as Cerebral Palsy on clinical basis were assessed for the type of cerebral palsy and the degree of associated developmental delay. Out of the total 100 patients 54% had quadriplegia, 32% had diplegia, 10% had himiplegia and 4% had monoplegia. The total fifty-four cases of quadriplegic cerebral palsy 54 had developmental delay and amongst them 4 [7%] had mild delay, 16 [30%] had moderate delay while 34 [63%] had severe delay. Amongst the total forty-six other three types of cerebral palsy 12 [26%] had mild delay, 6 [13%] had moderate delay and 28 [61%] had severe delay. The P-value was >0.05. Quadriplegic is the commonest type of CP, associated with the factors [peri-natal more than socio-demographic] and had significant effect on the developmental parameters