Factors associated with the severity of motor impairment in children with cerebral palsy seen in Enugu, Nigeria

Abstract

Background . Cerebral palsy (CP) is a heterogeneous condition that is well known to cause impairments with varying degrees of severity. The gross motor function classification system (GMFCS) is widely used to assess ambulatory function in CP, but little is known about the factors that account for the variations in gross motor function in children. The purpose of this study was to assess the relation between the severity of gross motor dysfunction (GMD) and certain factors such as the type of CP, aetiology of CP, nutrition, socioeconomic class (SEC), and the frequency of these accompanying impairments like visual, auditory, cognitive and speech impairments. Methods . This was a cross-sectional observational study of 100 consecutively recruited CP patients aged 9 - 96 months, who attended the paediatric neurology clinics (PNCs) in Enugu between April and October 2010. Each patient’s clinical history was recorded, a neurological examination conducted and GMFCS level ascertained. Statistical analyses were done to determine the association between the categorical variables. Results. The type of CP ( p =0.000), aetiological factors ( p =0.016), the presence of malnutrition ( p =0.004) and the frequency of accompanying impairments ( p =0.001) were significantly associated with the severity of GMD, while SEC ( p =0.649) had no significant association. Conclusion . The type of CP, aetiological factors, the presence of malnutrition and the number of accompanying physical, mental or physiological impairments, were positively associated with the severity of GMD and walking ability in children with CP.