Motor abilities, activities, and participation of institutionalized Brazilian children and adolescents with cerebral palsy

Mélo, Tainá Ribas; Yamaguchi, Bruna; Silva, Adriano Zanardi da; Israel, Vera Lúcia

doi:10.1590/S1980-6574201700SI0030

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Original Article • Motriz: rev. educ. fis. 23 (spe2) • 2017 • https://doi.org/10.1590/S1980-6574201700SI0030 copy

Motor abilities, activities, and participation of institutionalized Brazilian children and adolescents with cerebral palsy

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Aim:

To assess motor abilities and functioning of institutionalized children and adolescents with cerebral palsy (CP) within a contextual model of development.

Methods:

Eleven institutionalized Brazilian children and adolescents aged 2-19 (14 ± 5) years, 5 males and 6 females, were evaluated through the Gross Motor Function Measure (GMFM-88 and 66) and the Functional Independence Measure (FIM), and classified according to the ICF core set.

Results:

The evaluated individuals have severe impairments as indicated by their GMFM scores and confirmed by their need for full assistance in basic activities of daily living according to the FIM assessment. The difficulties manifested reflected on the ICF body functions and activities and participation domains.

Conclusion:

Most institutionalized children and adolescents with CP had GMFM-66 scores comparable to those indicated in literature. The ICF-based assessment identified environmental barriers that might be considered for improvement in order to facilitate activities and participation.

Keywords:
cerebral palsy, International Classification of Functionality, disability and health, physical therapy specialty, institutionalized children; motor skills

Child/ Adolescent	1	2	3	4	5	6	7	8	9	10	11
Sex	female	male	female	female	female	female	male	female	male	male	male
Age (years)	18	19	18	16	15	15	11	18	14	9	2
Clinical diagnosis	CP	CP	CP	CP	CP	CP	CP	CP	CP	CP+ WS	CP
Distribution of CP	diplegia	diplegia	diplegia	diplegia	quadriplegia	diplegia	quadriplegia	quadriplegia	quadriplegia	quadriplegia	quadriplegia
Type of CP	spastic	spastic	spastic	spastic	spastic	spastic	spastic	spastic	spastic	athetoid	spastic
GMFCS	II	IV	IV	IV	V	V	V	V	V	V	V
Impairment types	multiple (P+I)	multiple (P+I)	multiple (V+P+I)	multiple (P+I)	multiple (P+I)	multiple (V+P+I)	multiple (V+P+I)	multiple (P+I)	multiple (V+P+I)	multiple (V+P+I)	multiple (V+P+I)
*GMFM-88*
A (lying and rolling)	72.55	84.31	72.55	37.25	37.25	35.29	11.76	35.29	7.84	21.57	1.96
B (crawling and kneeling)	65.00	25.00	70.00	41.67	21.67	16.67	5.00	13.33	0.00	16.67	10.00
C (sitting)	26.19	7.14	14.29	9.52	0.00	0.00	0.00	0.00	0.00	0.00	0.00
D (standing)	48.72	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
E (walk-run-jump)	33.33	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
Mean	49.16	23.29	31.37	17.69	11.78	10.39	3.35	9.73	1.57	7.65	2.39
*GMFM-66 (number of items)*	54	66	54	65	66	66	66	65	66	66	66
Mean	53.32	29.96	39.73	33.37	26.02	24.66	13.54	24.01	0	18.89	12.12
SD	1.23	1.94	1.23	1.76	2	2	3	2	8.35	2.35	3.35

Functional Independence Measure		1	2	3	4	5	6	7	8	9	10	11
	A- Eating	2	1	1	1	1	1	1	1	1	1	1
	B- Grooming	1	1	1	1	1	1	1	1	1	1	1
	3. Bathing/showering	2	1	1	1	1	1	1	1	1	1	1
	4. Dressing upper body	2	1	1	1	1	1	1	1	1	1	1
	5. Dressing lower body	1	1	1	1	1	1	1	1	1	1	1
	6. Toileting	1	1	1	1	1	1	1	1	1	1	1
Sphincters	G- Bladder management	1	1	1	1	1	1	1	1	1	1	1
	H- Bowel management	1	1	1	1	1	1	1	1	1	1	1
Mobility	Transfers
	I. Transfers: bed/chair/wheelchair	6	2	1	1	1	1	1	1	1	1	1
	J. Transfers: toilet	1	1	1	1	1	1	1	1	1	1	1
	K. Transfers: bathtub/shower	1	1	1	1	1	1	1	1	1	1	1
Locomotion	L-Locomotion: walking/wheelchair	5	1	1	1	1	1	1	1	1	1	1
	M- Locomotion: stairs	4	1	1	1	1	1	1	1	1	1	1
Communication	N- Comprehension	2	6	1	1	3	1	1	3	1	1	1
	O- Expression	2	6	1	1	3	1	1	3	1	1	1
Psychosocial	P- Social Interaction	2	2	1	1	2	1	1	2	1	1	1
	Q- Problem-solving	1	3	1	1	1	1	1	1	1	1	1
	R- Memory	1	1	1	1	1	1	1	1	1	1	1

Children/Adolescents		1	2	3	4	5	6	7	8		9	10	11
ICF		Qualifiers
Structure Function	Structure of brain	s110	8	8	8	8	8	8	8	8	8	8	8
Body Functions	Intellectual function	b117	3	2	3	3	3	3	4	2	4	4	8
	Seeing function	b210	0	0	4	0	0	8	8	0	8	8	4
	Mobility of joint	b710	1	2	2	2	3	3	4	3	4	2	4
	Muscle tone functions	b735	1	2	2	2	2	3	4	3	4	3	4
	Control of voluntary movement functions	b760	1	2	2	2	3	3	4	3	4	4	4
Activities and Participation	Maintaining a body position	d415	1	2	1	2	3	3	4	3	4	4	4
	Fine hand use	d440	1	3	3	3	4	4	4	4	4	4	4
	Walking	d450	1	4	4	4	4	4	4	4	4	4	4
	Moving around in different locations	d460	2	4	3	4	4	4	4	4	4	4	4
	Toileting	d530	4	4	4	4	4	4	4	4	4	4	4
	Eating	d550	3	2	4	4	3	4	4	3	4	4	4
	Basic interpersonal interactions	d710	2	1	3	4	3	3	4	4	4	4	4
	Family relationships	d760	4	4	4	4	4	4	4	4	4	4	4
Environmental Factors	Products and technology for personal use in daily living	e115	1	3	4	4	4	4	4	4	4	4	8
	Products and technology for communication	e125	4	4	4	4	4	4	4	4	4	4	8
	Immediate family	e310	4	4	4	4	4	4	4	4	4	4	4
	Health services, systems, and policies	e580	+4	+4	+4	+4	+4	+4	+4	+4	+4	+4	+4

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[1] Corresponding author *Tainá Ribas Mélo, PT, Msc. Rua Coração de Maria, number 92, Campus Jardim Botânico, Curitiba, Paraná, Brazil. Email: ribasmelo@gmail.com