Evaluating functional independence with the Effect of Age and Gross Motor Function Classification System on Activities of daily livings of Children with cerebral palsy
Authors: Rai Shweta , Borah Tulika , Jain Varidmala , Saikia Jinamoni , Gogoi Sampreety , Das Mamoni , Saikia Hemanta 
Published: July 2024

Abstract

Background
Cerebral palsy is a neurological condition which basically affects the gross motor and fine motor functions of children; therefore, children need assistance in performing their activities of daily livings (ADL). In the Indian context, family-centered care is not seen commonly and the sole care is shouldered by the parents, mostly mother, which has an adverse effect on overall well-being of the family. A comprehensive picture of the characteristics of the children with CP, shedding light on their age distribution and motor function levels can assist to determine the extent of the problem, and develop systems to address issues pertaining to ADL.
Methods
Activities of daily living (ADL) problem faced by children were done through the use of a LTCS WeeFIM Score sheet -Brain Injury- July 2011 popularly used to assess the problem related to self-care, mobility, and cognition. In the present study self-care and mobility domains were assessed in children with cerebral palsy. The Gross Motor Function Classification System Expanded & Revised (GMFCS-E&R), a five-level classification system developed by Palisano et al. (2007), was employed to characterize the gross motor function of children with cerebral palsy across different age groups.
Children with cerebral palsy who were undertaking rehabilitation services in Trishla foundation and those who fulfilled the inclusive and exclusive criteria set for the study were selected purposely as sample for the study. The sample of the study consisted of 250 children who were undertaking rehabilitation services in the Trishla Foundation located at Prayagraj town of Uttar Pradesh, India. Out of these 250 children, 175 were above 3 years of age. Further, it was found that out of 175 children, only 65 children were in GMFCS I-III levels and rest were in GMFCS IV or V levels, who were omitted as per criteria of the study. Again, among the 65 children selected for the study, only 61 parents gave consent for their children to participate in the study. So finally, data were collected from 61 respondents.
Discussion
In the present study self-care and mobility domain were assessed in children with cerebral palsy. In case of need of assistance in self-care of children with cerebral palsy There were five sub-areas viz., eating, grooming, bathing, dressing upper body, dressing-lower body and 3 subareas in sphincter (control) viz., toileting, bladder management and bowel management. In regard of mobility there were 3 subareas related to transfers viz., transfers from chair/wheelchair to bed, transfers from chair/wheelchair to toilet and transfers from chair/wheelchair to tub and 2 subareas of locomotion, viz., walk/wheelchair/crawl and climbing stairs. Variations in the need of assistance werefound depending on the age and GMFCS level.
Conclusion
The study revealed noteworthy variations in the levels of independence and assistance required by individuals with cerebral palsy across different age groups and GMFCS levels in various activities of daily living.