Effect of Upper Extremity Functional Skills on Quality of Life and Participation of the Children With Cerebral Palsy
Condition: Cerebral Palsy; Diplegia; Upper Extremity Dysfunction; Quality of Life; Participation, Patient
MeSH terms: Paralysis; Cerebral Palsy
Study type: Observational [Patient Registry]

Summary: 
      Cerebral palsy (CP) is a movement and posture disorder accompanied by sensory, perception,
      cognition, communication and behavioral disorders that cause activity limitations by causing
      various non-progressive disorders of the fetal or infant brain. Spastic CP, according to the
      affected area in the body; It is classified as hemiparetic, diparetic and is observed most
      frequently. Diparetic CP, on the other hand, is characterized by significant spasticity in
      the pelvis and lower extremities, mild hypertonus or spasticity in the upper extremities, and
      incoordination, mostly involving the lower extremities and some upper extremities.Although
      lower extremity involvement is observed in different degrees in children with diparetic CP,
      studies showing how upper extremity and hand functions are affected are insufficient.The aim
      of this study is to compare the effect of upper extremity functional skills on quality of
      life and participation levels in children with diparetic CP with their healthy peers.
    

Detailed description: 
      Cerebral palsy (CP) is a movement and posture disorder accompanied by sensory, perception,
      cognition, communication and behavioral disorders that cause activity limitations by causing
      various non-progressive disorders of the fetal or infant brain. Spastic CP, according to the
      affected area in the body; It is classified as hemiparetic, diparetic and is observed most
      frequently. Diparetic CP, on the other hand, is characterized by significant spasticity in
      the pelvis and lower extremities, mild hypertonus or spasticity in the upper extremities, and
      incoordination, mostly involving the lower extremities and some upper extremities. Although
      lower extremity involvement is observed in different degrees in children with diparetic CP,
      studies showing how upper extremity and hand functions are affected are insufficient.Upper
      extremity functions are one of the most important factors that ensure participation in daily
      life for these children. Hands play a key role in the execution of activities of daily living
      (ADL), as well as being among the most important components affecting upper extremity
      functionality.Children with spastic type CP experience limitations in mobility due to the
      decrease in selective motor control, and as a result, they may experience losses in social
      life and limitations in participation in their ADLs. These children have various functional
      disabilities such as various gait disorders, lower extremity contractures and strength
      losses, trunk and postural control deficiencies, mobility problems, vision problems,
      behavioral and sensory problems, upper extremity strength and skill losses that affect school
      success. This situation causes them to encounter difficulties in taking an active role in
      life.

      Quality of life is a concept that shows the personal reactions to diseases that affect the
      level of personal satisfaction and to the physical, mental and social effects of daily
      life.Evaluation of quality of life in children with CP mostly includes physical symptoms,
      activity limitation, emotional stress, communication problems between child and family,
      limitation of school life, and determination of difficulties in the treatment of the disease.
      Decreased functional independence in children with CP compared to their healthy peers with
      typical development. Difficulties in activities of daily living, accompanying cognitive and
      sensory problems negatively affect quality of life.However, studies examining the
      relationship between upper extremity functional skills, quality of life and participation
      level in children with diparetic CP are insufficient in the literature.The aim of this study
      is to compare the effect of upper extremity functional skills on quality of life and
      participation levels in children with diparetic CP with their healthy peers.
    

Intervention name(s): All assessments of children (Demographic information, upper extremity skills, quality of life and participation levels)
Intervention type(s): Other
Intervention description(s): The researcher will fill out the personal information form containing the descriptive characteristics of the parents and children. GMFCS to assess children's functional levels, Manual Ability Classification System (MACS) to assess hand skills, Modified Ashworth Scale for upper extremity muscle spasticity, for upper extremity functional skills; Jebson Taylor Test, Abilhand Kids scale, for Quality of Life; The Quality of Life Scale for Children (PedsQL), PODCI criterion for participation levels will be administered by a physiotherapist who has 2 years of experience in the profession and works in the field of pediatric rehabilitation. The Jebson Taylor test and spasticity classification will be applied directly to the child by the physiotherapist, but other scales will be filled in by the parents under the supervision of the physiotherapist. .
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        diparetic cerebral palsy children between 6-15 years old and their healty peer aged
        children
      
Keywords: Upper Extremity Functions; Diparetic Cerebral Palsy; Quality of Life; Participation