Evaluation of effects of certain parameters related with hip joint on the functional capacity in children with cerebral palsy

Abstract

Cerebral palsy (CP) is a neuro-developmental disorder resulting from nonprogressive injury of immature brain tissue. Deformity of lower extremity is a frequently seen condition in children with CP. The changes in the hip joint and related anatomical structures affect the functional capacity and restrict ambulation of the children with CP.In this study, parameters like the collodiaphyseal angle (femoral inclination), acetabular index angle (AI), center edge angle (CE), migration percentage (MP) and pelvic obliquity (PO), which are used to evaluate the hip joint and its pathological changes, were measured. The effects of the obtained results on the functional capacity of the lower extremity that was assessed by the gross motor function measure were investigated in children with CP. The relationships of these parameters within the CP group and with the control group were examined. The CP group was composed of 34 children (24 hemiparetic and 10 diparetic, Gross Motor Functional Classification System level I) while the control group was composed of 26 children who visited the emergency department because of trauma without dislocation and broken of the hips, legs and spine.It was found that hemiparetic and diparetic children with CP, who were at the same GMFCS level and age group, had similar hip morphology. However, the results have revealed that hemiparetic children had better walking, running and jumping abilities than those of diparetics according to the gross motor function measure. No difference was determined between the children with CP and the control group regarding the measured parameters of hip morphology, except PO. Both in the children with CP and the control group, the femoral inclination angle was found to be higher bilaterally comparing with previous data. It was thought that the increase in AI angle of the diparetic children with CP may cause susceptibility to hip displacement.