Characteristics of selective motor control of the lower extremity in adults with bilateral spastic cerebral palsy.

Abstract

[Purpose] We aimed to examine the relationship between gross motor function, selective motor control (SMC), range of motion (ROM), and spasticity in the lower extremities of adults with cerebral palsy (CP), as well as the proximal to distal distribution of SMC impairment in lower extremity joints. [Participants and Methods] We recruited 11 adults with bilateral spastic CP, ranging from levels I to III according to the Gross Motor Function Classification System (GMFCS). We evaluated participants according to the Selective Control Assessment of the Lower Extremity (SCALE), ROM, and the Modified Ashworth Scale (MAS). We conducted the Friedman test to assess differences among the SCALE scores of each joint. The relationship between GMFCS level, SCALE scores, ROM, and MAS scores was assessed. [Results] The mean SCALE scores were lower for distal than for proximal joints. The SCALE scores of each leg showed significant inverse correlations with the GMFCS level. [Conclusion] SMC in adults with CP strongly influences gross motor function. SMC did not have a significant relationship with spasticity or ROM. SMC, ROM, and spasticity independently influenced gross motor function in adults with CP. SMC impairment in adults with CP was higher in distal than in proximal joints.