Abstract
Background: Impaired motor function is the hallmark of cerebral palsy and could present with grave implications particularly in resource limited settings. Consequently the identification of motor function and mobility needs in children with cerebral palsy in such settings is vital to providing optimal care. Objective: To describe the gross motor function in children with cerebral palsy presenting to a child neurology service in Zaria, north-western Nigeria. Methods: A review of the gross motor function, using the Gross Motor Function Classification System Expanded and Revised (GMFCS- E&R), of children with cerebral palsy (Subjects) who were in steady state of health and who presented at Neurology Clinic of the Departments of Paediatrics and Physiotherapy, of the Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria over a five year period was under taken. Other parameters assessed were: age, sex, identified predisposing factor for cerebral palsy, clinical type of cerebral palsy, mode of transport and social class of the subjects. Results: A total of 235 subjects with age range 5 months to 11 years (mean 2.6 ± 2.4 years) were studied. Of the subjects 148 were males and 87 females (M.F, 1.7:1). Most of the subjects were under 2 years of age (169, 71.91%), in the upper social classes (182, 77.45%), had the spastic clinical type of cerebral palsy (184, 78.30%) and birth asphyxia (106, 45.1%) as the commonest identifiable predisposing factor. Majority of the subjects (143, 60.9%) had severe limitation (GMFCS-E&R Levels IV&V) in gross motor function and this was significantly (pE0.05) associated with age less than 2 years and spastic type of cerebral palsy. Out of the 205 (87.2%) Subjects who needed a transport mobility device only 14(6.8%) of them utilized one. Conclusion: The study was characterized by severe limitation in gross motor function and limited utilization of mobility devices in the subjects. It underscores the need to address mobility issues in children with cerebral palsy in the environment.
Highlights
Cerebral palsy is a significant cause of childhood physical disability [1]
The study was characterized by severe limitation in gross motor function and limited utilization of mobility devices in the subjects
The recorded gross motor function of children with cerebral palsy who presented at the Neurology Clinic of the Department of Paediatrics, and the Department of Physiotherapy, Ahmadu Bello University Teaching Hospital (ABUTH) Shika-Zaria over a five year period, between January 2005 and December 2009, were reviewed
Summary
Cerebral palsy is a significant cause of childhood physical disability [1]. It has been described as “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The use of several treatment modalities such as physiotherapy, botulinum toxin, intrathecal baclofen injections, orthopedic surgery and utilization of orthoses, for impairment in motor functioning, have been reported with variable successes [15,16]. Utilization of these contemporary modalities is limited in settings like ours, where management of children with special health care needs such as in cerebral palsy, is challenged by dearth of specialist care providers and services, high cost of accessing care where available, paucity of health information, poor traditional practices and a high expectation of recovery by caregivers [17,18,19]. The identification of motor function and mobility needs in children with cerebral palsy in such settings is vital to providing optimal care
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