PERFORMANCE OF ACTIVITIES BY ADOLESCENTS WITH CEREBRAL PALSY

Abstract

Purpose/Hypothesis: Knowledge of performance of activities in daily life by adolescents with cerebral palsy is important for transition planning to young adulthood. The purpose of this study was to describe how often adolescents with cerebral palsy perform activities by themselves. The hypothesis was that performance differs based on Gross Motor Function Classification System (GMFCS) level. Number of Subjects: 195 adolescents with cerebral palsy, 11-18 years of age. Subjects were selected from a population based sample of children with cerebral palsy in Ontario Canada who had participated in a study of gross motor development. Materials/Methods: The Activity Scale for Kids performance version (ASKp) was self-completed by 154 adolescents and by a parent of 41 adolescents. The ASKp includes 30 items on personal care, dressing, standing skills, transfers, locomotion, and play/recreation. How often each item was performed in the past week is rated on a 5-point scale. Response options range from “all of the time” to “none of the time”. The maximum score is 100. A therapist classified gross motor function using the 5-level GMFCS. Results: A one-way ANOVA indicated a significant (P < 0.001) difference in mean ASKp scores: 90.2 (level I), 64.6 (level II), 57.9 (level III), 25.0 (level IV), 10.4 (level V). Post-hoc multiple comparisons indicated that ASKp scores differed between GMFCS levels except for levels II and III. Most adolescents in level I reported that in the past week they performed each activity by themselves all of the time. The majority of adolescents in levels II and III reported that they performed personal care and dressing activities by themselves all or most of the time; where as the majority reported performing sports and manual activities sometimes, once in a while, or never. The majority of adolescents in levels IV and V reported that they performed activities by themselves none of the time. Conclusions: Performance of activities in daily life by adolescents with cerebral palsy differed based on GMFCS level. The finding that scores did not differ between adolescents in levels II and III may reflect similarities in fine motor abilities, which are not considered in the GMFCS. Clinical Relevance: The results suggest that assistive technology, environmental modifications, and opportunity for participation in physical and sports activities are considerations for increasing performance of activities of adolescents with cerebral palsy, particularly adolescents in levels IV and V.