An investigation into the factors which affect the sitting balance of non-ambulatory children with cerebral palsy

Abstract

Background & Objective: This study aimed to examine the factors affecting sitting function in non- ambulatory children with cerebral palsy (CP) who spend most of their daily life in a sitting position. Methods: Thirty- five non-ambulatory children with CP were included in this cross sectional study. Data included demographics, socio-economic features, examination findings, personal and family history, and accompanying problems of patients. The participants’ lower extremity spasticity was evaluated using the Modified Ashworth scale (MAS); manual ability was evaluated using the Manual Ability Classification System (MACS); sitting function using the Gross Motor Functional Measure (GMFM)-sitting subscale; and trunk control using the Trunk Impairment Scale (TIS). The relationship between sitting function and the other evaluation parameters was analyzed. Results: Children with scoliosis had significantly lower scores in TIS-static and TIS-total (p<0.05). Hip problems negatively affected the GMFM-sitting subscale, TIS-static, and TIS-total (p<0.05). Strong positive correlations were found between GMFM- B (sitting subscale) scores and TIS-static, dynamic, coordination, and TIS-total scores (p<0.05). Duration of hospitalization in neonatal intensive care and MACS were correlated with GMFM-B (p<0.05). Multivariate analyses showed that trunk control and upper extremity function were independent risk factors on sitting function. Conclusion: More attention should be paid to rehabilitation programs which incorporate trunk control exercises and upper extremity functions in order to improve sitting function. Preventing hip dislocation may be an option to increase sitting function of non-ambulatory children with CP.