The effect of cerebral palsy on self-care, mobility, and social function.

摘要

The purpose of this research study was to determine whether the type and severity of cerebral palsy has an effect on functional performance and level of caregiver assistance in self-care, mobility, and social function for children, adolescents, and young adults with cerebral palsy between the ages of 0 and 19 years of age. Using a retrospective, longitudinal cohort type research methodology, this research study examined the effects of cerebral palsy on self-care, mobility, and social function for 2,768 children, adolescents, and young adults with cerebral palsy through convenience sampling using multiple linear regression to predict functional performance and level of caregiver assistance by type and severity of cerebral palsy, as well as covariates, including age, gender, and ethnicity. The type of cerebral palsy (medical diagnosis) did not have a significant effect on self-care, mobility, and social function for functional skills and the level of caregiver assistance. However, the severity of cerebral palsy had the strongest effect on self-care, mobility, and social function, as measured by the Gross Motor Function Classification System -- Expanded and Revised (GMFCSE & R) and the Manual Ability Classification System (MACS), with a more severe level of gross motor and fine motor function resulting in a lower level of self-care, mobility, and social function and a less severe level of gross motor and fine motor function resulting in a higher level of self-care, mobility, and social function for both functional skills and the level of caregiver assistance. The severity of cerebral palsy, as measured by the Gross Motor Function Classification System -- Expanded & Revised, significantly predicted Self-Care (Functional Skills), beta = - 2.2, t(2768) = -10.5, p .001, Mobility (Functional Skills), beta = -9.5, t(2768) = - 49.4, p .001, Social Function (Functional Skills), beta = -1.4, t(2768) = -4.9, p .001, Self-Care (Caregiver Assistance), beta = -1.3, t(2768) = -9.1, p .001, Mobility (Caregiver Assistance), beta = -5.2, t(2768) = -36.2, p .001, and Social Function (Caregiver Assistance), beta = -0.6, t(2768) = -4.4, p .001. The severity of cerebral palsy, as measured by the Manual Ability Classification System also significantly predicted Self-Care (Functional Skills), beta = -11.3, t(2768) = -44.2, p .001, Mobility (Functional Skills), beta = -3.2, t(2768) = -13.7, p .001, Social Function (Functional Skills), beta = -9.2, t(2768) = -26.9, p .001, Self-Care (Caregiver Assistance), beta = -5.7, t(2768) = -32.4, p .001, Mobility (Caregiver Assistance), beta = -2.7, t(2768) = -15.5, p .001, and Social Function (Caregiver Assistance), beta = -3.9, t(2768) = -23.2, p .001. Age also significantly predicted Self-Care (Functional Skills), beta = 1.4, t(2768) = 12.8, p .001, Mobility (Functional Skills), beta = 1.1, t(2768) = 11.3, p .001, Social Function (Functional Skills), beta = 1.1, t(2768) = 9.7, p .001, Self-Care (Caregiver Assistance), beta = 0.8, t(2768) = 11.4, p .001, Mobility (Caregiver Assistance), beta = 0.8, t(2768) = 10.7, p .001, and Social Function (Caregiver Assistance), beta = 0.5, t(2768) = 6.7, p .001. This study provided the needed evidence for more effective occupational therapy and physical therapy treatment planning, caregiver education, and clinical resource utilization through analysis of the severity of cerebral palsy, as measured by the Gross Motor Function Classification System -- Expanded and Revised (GMFCS- E & R) and the Manual Ability Classification System (MACS), as well as the age of the child.