Abstract
ObjectiveManual ability is considered one of the factors that can predict functional independence in activities of daily living. For evaluating personal tasks such as self-care, the Pediatric Evaluation of Disability Inventory (PEDI) comprises/introduces/offers a set of useful measures that assist in enhancing the capability for self-care among children and adolescents with cerebral palsy (CP). The aim of this study was to investigate the relevant factors of self-care capability and performance in children and adolescents with spastic CP.MethodsThis was a cross-sectional study. Seventy-six children and adolescents with spastic CP (between 5 and 18 years of age), representing levels I to IV of the Gross Motor Function Classification System-Expanded & Revised version (GMFCS), were analyzed. Multiple linear regression analysis with forward stepwise selection was conducted to examine which determinants were related to self-care capability and performance. Independent variables were age, CP type, GMFCS, Manual Ability Classification System, Box and Block Test, and grip strength in the dominant and non-dominant hands. Dependent variables were scores for the PEDI Functional Skills Scale and the PEDI Caregiver Assistance Scale.ResultsResults of the multiple regression analysis showed that the PEDI Functional Skills scale scores were correlated with the Box and Block Test in the dominant hand and GMFCS (Adjusted R2 = 0.69). The PEDI Caregiver Assistance Scale scores were correlated with the Box and Block Test in the dominant hand, GMFCS, and age (adjusted R2 = 0.71).ConclusionWhen considering self-care of children and adolescents with spastic CP, it is necessary to consider the evaluation of upper limb dysfunction in addition to GMFCS.
Highlights
Children with cerebral palsy (CP) present with various upper extremity impairments, including muscle weakness, impaired motor fluency, accuracy, dexterity, and adaptability to the environment [1,2]
Results of the multiple regression analysis showed that the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skills scale scores were correlated with the Box and Block Test in the dominant hand and GMFCS (Adjusted R2 = 0.69)
The PEDI Caregiver Assistance Scale scores were correlated with the Box and Block Test in the dominant hand, GMFCS, and age
Summary
Children with cerebral palsy (CP) present with various upper extremity impairments, including muscle weakness, impaired motor fluency, accuracy, dexterity, and adaptability to the environment [1,2]. Children with CP often have difficulty grasping, releasing, and manipulating objects—all skills needed for daily living activities [4]. Many children can efficiently perform activities of daily living (ADL) with one hand, but most manual ADL are easier to perform using both hands. Dominant hand (DH) performance of activities requiring manual dexterity is better than nondominant hand (NDH) performance in children with CP; this applies to both fine and gross manual dexterity [5]. Manual ability should be evaluated given its importance in the daily activities of children and adolescents [6]
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