Comprehensive evaluation (demographic and functional) for predicting independent ambulation in spastic Cerebral Palsy

Abstract

Introduction: Cerebral palsy (CP) is the most common childhood physical disability and affects 2 to 2.5 children per 1,000 born. A complete neurodevelopment assessment of the child with cerebral palsy is performed by a multidisciplinary clinical team, and should include a comprehensive evaluation of clinical and functional status, etiological risk determinants, associated deficits and environmental factors that influence participation and ambulation.
Objective: This study aimed to identify positive and negative prognostic factors for independent ambulation in a group of children with cerebral palsy.
Materials and Methods: A total of 52 children with spastic CP, who were rehabilitated in the paediatrics rehabilitation clinic between 2005-2010 years, were included. All subjects received a standardized physical therapy protocol (kinetotherapy and electrotherapy). They were completely social, economical, clinical and functional evaluated for a period of 2 years.
Results: The main parameters of the progression to the acquisition of independent walking were negative risk factors (the topography of spasticity with both legs, paraparesis and tetraparesis, presence of associated disorders as epilepsy, mental retardation, high levels of muscle spasticity of the lower limb flexors) and favourable prognostic factors (the mean reduction of spasticity scores between times of assessments, the greater the amplitude of movement in the AM limb joints, the improving AM from an assessment at another, and a high score of BBS).
Conclusion: We believe that these results could be useful for both clinicians and physical therapists in monitoring the application rehabilitation program and as prognostic factors for independent ambulation of cerebral palsied children.

Key words:

cerebral palsy, ambulation, risk factors