Pekesen Kurtça M1, Angın S2
1Pamukkale University, Vocational School of Health Services Therapy and Rehabilitation Department, Denizli, Turkey, 2Dokuz Eylul University, School of Physical Therapy and Rehabilitation, Izmir, Turkey
Background: As children with cerebral palsy mature into adulthood, their condition can present some added challenges. While most of the resources on cerebral palsy focus on children and toddlerhood, there are countless adults with cerebral palsy (CP) who go on to live a full life.
Secondary problems directly or indirectly associated with CP occur during late adolescence and adulthood. General trend is becoming less mobile for individuals with CP who have been reached adulthood. This situation hinders independent living onward and led to functional loss. Finding proper health care and continued support is essential for quality of life. By establishing the best ways to manage their symptoms, young people with CP will be able to make the most out of life as they mature into adulthood.
Purpose: This study aimed to investigate the relationship between spasticity, mobility and activity level in adults with CP.
Methods: Thirty four individuals with spastic cerebral palsy who were fifteen years and over included in this study. The demographic and clinical features were recorded, and spasticity was assessed with the modified ashworth scale (MAS). Rivermead Mobility İndex (RMI) , mobility, self-care and locomotion parameters of Functional İndependence Measure (FIM) were conducted to analyse level of mobility and activity. Gross Motor Function Classification System (GMFCS) was applied for each subject. All subjects splitted to two groups: Group 1 consisted with level 1, 2 and 3; group 2 consisted with level 4 and 5 according to GMFCS score. Pearson Correlation Analysis, Kruskal Wallis Analysis of Variance and Mann- Whitney U Test were performed for data analysis. α Level was set 0.05.
Results: Total modified ashworth scale ratings was found to be significantly and reversely correlated with GMFCS level, RMI, locomotion, mobility scores (p 0.05). Correlation between modified ashworth scale ratings and self-care scores was found to be non- significant (p>0.05). Within group comparison, MAS, RMI, locomotion, mobility, self care and total FIM score was found to be significantly different (p 0.05). RMI scores in hemiparetic group were found to be significantly different when the patients allocated among the three groups as hemiparetic, diparetic and quadriparetic according to the extremity involvement (p 0.05). Spasticity values and motor limitations of the hemiparetic group were found to be lower than the other groups (p 0.05), but there was no difference between hemiparetic individuals and other groups in terms of mobility and locomotion parameters of FIM. However, it was determined that the RMI score, which assesses the level of mobility in the social areas, is higher in hemiparetic individuals.
Conclusion(s): Since the mobility and activity level negatively effected by spasticity in adult patients with cerebral palsy, the spasticity managment methods should not be underestimated for increasing functional level and mobility.
Implications: It is important to identify factors that affect the level of mobility because the mobility is the main factor that determines the average life expectancy.
The initial assessment should be based on mobility and the physiotherapist should consider the difference between performance and capacity.
Keywords: Spasticity, Mobility, Activity Level
Funding acknowledgements: This study was unfunded.
Secondary problems directly or indirectly associated with CP occur during late adolescence and adulthood. General trend is becoming less mobile for individuals with CP who have been reached adulthood. This situation hinders independent living onward and led to functional loss. Finding proper health care and continued support is essential for quality of life. By establishing the best ways to manage their symptoms, young people with CP will be able to make the most out of life as they mature into adulthood.
Purpose: This study aimed to investigate the relationship between spasticity, mobility and activity level in adults with CP.
Methods: Thirty four individuals with spastic cerebral palsy who were fifteen years and over included in this study. The demographic and clinical features were recorded, and spasticity was assessed with the modified ashworth scale (MAS). Rivermead Mobility İndex (RMI) , mobility, self-care and locomotion parameters of Functional İndependence Measure (FIM) were conducted to analyse level of mobility and activity. Gross Motor Function Classification System (GMFCS) was applied for each subject. All subjects splitted to two groups: Group 1 consisted with level 1, 2 and 3; group 2 consisted with level 4 and 5 according to GMFCS score. Pearson Correlation Analysis, Kruskal Wallis Analysis of Variance and Mann- Whitney U Test were performed for data analysis. α Level was set 0.05.
Results: Total modified ashworth scale ratings was found to be significantly and reversely correlated with GMFCS level, RMI, locomotion, mobility scores (p 0.05). Correlation between modified ashworth scale ratings and self-care scores was found to be non- significant (p>0.05). Within group comparison, MAS, RMI, locomotion, mobility, self care and total FIM score was found to be significantly different (p 0.05). RMI scores in hemiparetic group were found to be significantly different when the patients allocated among the three groups as hemiparetic, diparetic and quadriparetic according to the extremity involvement (p 0.05). Spasticity values and motor limitations of the hemiparetic group were found to be lower than the other groups (p 0.05), but there was no difference between hemiparetic individuals and other groups in terms of mobility and locomotion parameters of FIM. However, it was determined that the RMI score, which assesses the level of mobility in the social areas, is higher in hemiparetic individuals.
Conclusion(s): Since the mobility and activity level negatively effected by spasticity in adult patients with cerebral palsy, the spasticity managment methods should not be underestimated for increasing functional level and mobility.
Implications: It is important to identify factors that affect the level of mobility because the mobility is the main factor that determines the average life expectancy.
The initial assessment should be based on mobility and the physiotherapist should consider the difference between performance and capacity.
Keywords: Spasticity, Mobility, Activity Level
Funding acknowledgements: This study was unfunded.
Topic: Disability & rehabilitation; Paediatrics: cerebral palsy
Ethics approval required: Yes
Institution: Dokuz Eylül University Faculty of Medicine
Ethics committee: Clinical and Laboratory Research Ethics Committee
Ethics number: 154-İOÇ ,2010/11- 24
All authors, affiliations and abstracts have been published as submitted.
