Motor Disability Research Articles

Mindspeak: Empowering Communication with Brain Keyboard

Brain-Computer Interface (BCI) technology stands as a groundbreaking innovation, revolutionizing the way individuals with severe motor disabilities interact with the world. The integration of Electroencephalogram (EEG) sensors within applications like the Brain Keyboard marks a pivotal stride forward. By capturing and interpreting brain signals triggered by simple actions such as eye blinking, these sensors empower users to control a virtual keyboard, transcending the limitations imposed by traditional motor pathways. This direct channel between the human brain and external devices offers an unprecedented avenue for communication, particularly invaluable for those grappling with conditions like paralysis or locked-in syndrome. The profound impact of BCIs extends far beyond facilitating textual communication; they represent a lifeline, a bridge toward autonomy and engagement for individuals facing profound physical challenges. Through these interfaces, users can articulate thoughts, express emotions, and actively participate in social interactions, fundamentally enhancing their quality of life. This technological marvel not only breaks down communication barriers but also holds promise in broader applications. As BCIs evolve, their potential encompasses enabling control over robotic prosthetics, granting users the ability to accomplish tasks once deemed impossible. Moreover, the implications of BCIs stretch into the realm of neuroscience, offering a unique window into understanding cognitive processes and neurological disorders. The ability to decode and interpret brain activity not only aids in facilitating communication but also paves the way for groundbreaking research and potential therapies. Challenges persist, such as enhancing signal accuracy and streamlining usability, yet the remarkable benefits that BCIs offer to individuals with motor disabilities continue to fuel ongoing innovation in this dynamic field. Ultimately, the fusion of EEG sensors, processing units, and user interfaces in BCIs heralds a new era of inclusivity and empowerment, where individuals previously marginalized by physical limitations find newfound avenues for expression, interaction, and independence. This transformative technology not only unlocks communication but also holds the key to reshaping our understanding of the human brain and its intricate workings, promising a f uture where disabilities no longer confine one's ability to engage with the world.

The role of DEAD- and DExH-box RNA helicases in neurodevelopmental disorders.

Neurodevelopmental disorders (NDDs) represent a large group of disorders with an onset in the neonatal or early childhood period; NDDs include intellectual disability (ID), autism spectrum disorders (ASD), attention deficit hyperactivity disorders (ADHD), seizures, various motor disabilities and abnormal muscle tone. Among the many underlying Mendelian genetic causes for these conditions, genes coding for proteins involved in all aspects of the gene expression pathway, ranging from transcription, splicing, translation to the eventual RNA decay, feature rather prominently. Here we focus on two large families of RNA helicases (DEAD- and DExH-box helicases). Genetic variants in the coding genes for several helicases have recently been shown to be associated with NDD. We address genetic constraints for helicases, types of pathological variants which have been discovered and discuss the biological pathways in which the affected helicase proteins are involved.

Asymmetric multi-task learning for interpretable gaze-driven grasping action forecasting.

This work tackles the problem of automatically predicting the grasping intention of humans observing their environment, with eye-tracker glasses and video cameras recording the scene view. Our target application is the assistance to people with motor disabilities and potential cognitive impairments, using assistive robotics. Our proposal leverages the analysis of human attention captured in the form of gaze fixations recorded by an eye-tracker on the first person video, as the anticipation of prehension actions is a well studied and well known phenomenon. We propose a multi-task system that simultaneously addresses the prediction of human attention in the near future, and the anticipation of grasping actions. In our model, visual attention is modeled as a competitive process between a discrete set of states, each one associated to a well-known gaze movement pattern from visual psychology. We additionally consider an asymmetric multitask problem, where attention modeling is an auxiliary task that helps to regularize the learning process of the main action prediction task, and propose a constrained multi-task loss that naturally deals with this asymmetry. Our model shows superior performance than other losses for dynamic multi-task learning, current dominant deep architectures for general action forecasting and particularly-tailored models for predicting grasping intention. In particular, it provides state-of-the-art performance in three datasets for egocentric action anticipation, with an average precision of 0.569 and 0.524 in GITW and Sharon datasets, respectively, and an accuracy of 89.2% and a success rate of 51.7% in Invisible dataset.

Exploring the use of computer vision in assistive technologies for individuals with disabilities: A review

A wide range of obstacles faced by people with disabilities, such as visual impairment, motor disability, and communication difficulties, have shown significant promise for being addressed by computer vision. The state-of-the-art in computer vision-based assistive technology is examined in this report along with major future research topics and obstacles. In particular, this study explores how computer vision can be used for object recognition, navigation, facial recognition, sign language interpretation, and gesture-based control interfaces. It also discusses the benefits and drawbacks of various methodologies and technologies and offers examples of how computer vision can be incorporated into current assistive technologies to boost their efficacy. The ethical and privacy issues surrounding the use of computer vision in assistive technologies are covered in this study effort. The study also highlights the need for protocol standardization, better user-centered design, and the assessment of real-world effectiveness as future research objectives for improving the use of computer vision in assistive technology. Overall, this paper sheds light on how computer vision might completely alter the world of assistive technologies for people with impairments.

A Robotic Exoskeleton Assistive Device: Design and Kinematic Analysis of a Hand Exoskeleton for Assistance

Addressing the challenges faced by individuals with motor disabilities, which impedes ease in movement, coordination, or sensation, a low-weight hand exoskeleton was developed considering accessibility, low cost, adaptability, and mass manufacturing to overcome the impact of hand functioning disorders on people's physical and social well-being. In this paper, a 12-DOF Hand exoskeleton consisting of a 6-DOF Arm and 6-DOF finger exoskeleton was designed and later its kinematic analysis was performed. By taking into consideration the constraints provided by the exoskeleton to human hand motion, the Forward kinematics, using Denavit- Hartenberg (D-H) parameters were conducted to determine its workspace.

A Delphi Exploration of Toileting Activity Performance in Individuals With Cerebral Palsy Within the ICF-CY Framework: Unveiling Influential Factors.

Introduction: Cerebral palsy (CP) is a common motor and postural developmental disability impacting daily activities like toileting. Despite its importance, toileting has often been undervalued in healthcare. This study is aimed at identifying and assessing the level of influence of various factors affecting toileting in individuals with CP using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) framework. Methods: The Delphi method was employed to reach a consensus on factors influencing toileting in individuals with CP. One hundred fifty-eight professionals from 17 countries, each with at least 3 years' experience in CP and/or toileting, participated in this two-round study. Ethical approval (IR.IUMS.REC.1400.1111) and informed consent were obtained. The questionnaire, available in Farsi and English, used a Likert scale (5 = very high impact to 1 = no impact). Factors with 75% agreement and a mean above 3.75 were included in the final list, while those with 50%-75% agreement or a mean between 2.5 and 3.75 proceeded to the second round. Factors were initially identified through a literature review and research team consultation and categorized according to the ICF-CY framework using the ICF 10 RULES. Validation and refinement were done through focus groups with caregivers and experienced professionals to ensure alignment with the framework and methodological rigor. Results: The study highlighted significant factors influencing toileting activities in individuals with CP. Within the ICF-CY framework, "neuromusculoskeletal and movement-related functions" scored highest at 94.5% in "body functions and structures." "Toilet environment" scored 90.5% in "environmental factors." Support and relationship factors scored 82.3%. Attitudes toward "menstruation" ranked highest at 92.9%. Associated deficits with CP ranked top in personal factors at 93.7%. Conclusion: The study identifies key factors influencing toileting activity performance in individuals with CP. "Main caregiver" emerges as a pivotal factor, followed by neuromusculoskeletal functions, personal factors, attitudes toward menstruation, the toilet environment, and support and relationships.

Understanding the spectrum of non-motor symptoms in multiple sclerosis: insights from animal models.

Multiple sclerosis is a chronic autoimmune disease of the central nervous system and is generally considered to be a non-traumatic, physically debilitating neurological disorder. In addition to experiencing motor disability, patients with multiple sclerosis also experience a variety of non-motor symptoms, including cognitive deficits, anxiety, depression, sensory impairments, and pain. However, the pathogenesis and treatment of such non-motor symptoms in multiple sclerosis are still under research. Preclinical studies for multiple sclerosis benefit from the use of disease-appropriate animal models, including experimental autoimmune encephalomyelitis. Prior to understanding the pathophysiology and developing treatments for non-motor symptoms, it is critical to characterize the animal model in terms of its ability to replicate certain non-motor features of multiple sclerosis. As such, no single animal model can mimic the entire spectrum of symptoms. This review focuses on the non-motor symptoms that have been investigated in animal models of multiple sclerosis as well as possible underlying mechanisms. Further, we highlighted gaps in the literature to explain the non-motor aspects of multiple sclerosis in experimental animal models, which will serve as the basis for future studies.

Magnitude and clinical characteristics of cerebral palsy among children in Africa: A systematic review and meta-analysis.

Cerebral palsy (CP) is the most common motor disability in childhood which causes a child's behavioral, feeding, and sleep difficulties. It remains a poorly studied health problem in Africa. The main aim of this study was assessing the pooled prevalence of Cerebral Palsy (CP) and its clinical characteristics in Africa context. Systematic review and meta-analysis were conducted using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search articles from electronic databases (Cochrane library, Ovid platform) (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, Maternity and Infant Care Database (MIDIRS). The last search date was on 12/05/ 2023 G. C. A weighted inverse variance random-effects model was used to estimate the pooled estimates of cerebral palsy and its types. The subgroup analysis, publication bias and sensitivity analysis were done. Studies on prevalence and clinical characteristics of cerebral palsy were included. The primary and secondary outcomes were prevalence and clinical characteristics of cerebral palsy respectively. A total of 15 articles with (n = 498406 patients) were included for the final analysis. The pooled prevalence of cerebral palsy in Africa was found to be 3·34 (2·70, 3·98). The most common type is spastic cerebral palsy accounting 69·30% (66·76, 71·83) of all cases. The second one is quadriplegic cerebral palsy which was found to be 41·49% (33·16, 49·81). Ataxic cerebral palsy accounted 5·36% (3·22, 7·50). On the other hand, dyskinetic cerebral palsy was found to be 10.88% (6·26, 15·49). About 32·10% (19·25, 44.95) of cases were bilateral while 25·17% (16·84, 33·50) were unilateral. The incidence of cerebral palsy in Africa surpasses the reported rates in developed nations. Spastic and quadriplegic subtypes emerge as the most frequently observed. It is recommended to channel initiatives toward the strategic focus on preventive measures, early detection strategies, and comprehensive management protocols.

A Growing Bubble Speller Paradigm for Brain-Computer Interface Based on Event-related Potentials.

Event-related potentials (ERPs) reflect electropotential changes within specific cortical regions in response to specific events or stimuli during cognitive processes. The P300 speller is an important application of ERP-based brain-computer interfaces (BCIs), offering potential assistance to individuals with severe motor disabilities by decoding their electroencephalography (EEG) to communicate. This study introduced a novel speller paradigm using a dynamically growing bubble (GB) visualization as the stimulus, departing from the conventional flash stimulus (TF). Additionally, we proposed a "Lock a Target by Two Flashes" (LT2F) method to offer more versatile stimulus flash rules, complementing the row and column (RC) and single character (SC) modes. We applied the "Sub and Global" multi-window mode to EEGNet (mwEEGNet) to enhance classification and explored the performance of eight other representative algorithms. Twenty healthy volunteers participated in the experiments. Our analysis revealed that our proposed pattern elicited more pronounced negative peaks in the parietal and occipital brain regions between 200 ms and 230 ms post-stimulus onset compared with the TF pattern. Compared to the TF pattern, the GB pattern yielded a 2.00% increase in online character accuracy (ACC) and a 5.39 bits/min improvement in information transfer rate (ITR) when using mwEEGNet. Furthermore, results demonstrated that mwEEGNet outperformed other methods in classification performance. These results underscore the significance of our work in advancing ERP-based BCIs.

Chapter 16 - Disease-specific interventions using cell therapies for spinal cord disease/injury

Traumatic spinal cord injury (SCI) may occur across the lifespan and is of global relevance. Damage of the spinal cord results in para- or tetraplegia and is associated with neuropathic pain, spasticity, respiratory, and autonomic dysfunction (i.e., control of bladder-bowel function). While the acute surgical treatment aims at stabilizing the spine and decompressing the damaged spinal cord, SCI patients require neurorehabilitation to restore neural function and to compensate for any impairments including motor disability, pain treatment, and bladder/bowel management. However, the spinal cord has a limited capacity to regenerate and much of the disability may persist, depending on the initial lesion severity and level of injury. For this reason, and the lack of effective drug treatments, there is an emerging interest and urgent need in promoting axonal regeneration and remyelination after SCI through cell- and stem-cell based therapies. This review briefly summarizes the state-of the art management of acute SCI and its neurorehabilitation to critically appraise phase I/II trials from the last two decades that have investigated cell-based therapies (i.e., Schwann cells, macrophages, and olfactory ensheathing cells) and stem cell-based therapies (i.e., neural stem cells, mesenchymal, and hematopoietic stem cells). Recently, two large multicenter trials provided evidence for the safety and feasibility of neural stem cell transplantation into the injured cord, whilst two monocenter trials also showed this to be the case for the transplantation of Schwann cells into the posttraumatic cord cavity. These are milestone studies that will facilitate further interventional trials. However, the clinical adoption of such approaches remains unproven, as there is only limited encouraging data, often in single patients, and no proven trial evidence to support regulatory approval.

Rate of motor progression in Parkinson's disease: a systematic review and meta-analysis.

The search for neuroprotective treatments for Parkinson's disease (PD) still relies largely on motor disability scales. A limitation of these tools is the strong influence of symptomatic dopaminergic treatment effects. Drawing on a wealth of published information, we conducted a systematic review and meta-analysis of motor progression in PD and its relationships with dopaminergic therapy. We searched Medline, Embase, and Central to identify 84 publications with adequate serial motor scores to calculate progression, expressed as an increase in the percentage of maximum disability. A random-effects model showed motor progression at 2.0% p.a. (95% CI 1.7-2.4%). There were no significant differences by baseline age, sample size, or observation period. However, untreated patients, in 8 publications, progressed at 4.5% p.a. compared to 1.6% p.a. in 76 studies containing individuals on dopaminergic drugs (p = 0.0004, q = 0.003). This was supported by research on phenoconversion in prodromal PD, where motor progression exceeded 5% p.a. in the 2 years before diagnosis. Starting levodopa improved pre-treatment disability by 40.3 ± 15.2%. Practically defined off state measurements increase faster than on scores by a modest degree (p = 0.05). This survey suggests that accurate long-term measurements of motor progression to assess disease-modifying therapies can be conducted despite the sequential commencement of dopaminergic drugs and sample attrition over time. While study designs involving prodromal or untreated PD avoid confounding effects of symptomatic treatment, different assumptions about motor progression may be needed. A defined off state with the levodopa test dose method maximizes information about the medication cycle once dopaminergic therapy has begun.

Evaluation of spatial quality and use of urban park: Case study of the Joaquim Amaral Amando de Barros Municipal Park in Botucatu, SP

Public spaces play an important role in urban life, as they are spaces that enable social relations, health and well-being. Those spaces aimed at leisure, such as urban parks, aim to offer the population, in addition to contact with nature, the development of physical activities and recreation for various age groups. The good quality of the spatial configuration encourages the permanence of users in the place and enables social interaction. However, the impoverishment of public space projects leads to their disuse. In this context, this article presents the result of a research that evaluated the spatial quality and use of an urban park. The case study was carried out in the Joaquim Amaral Amando de Barros Municipal Park, located in the city of Botucatu, SP. From an adaptation of the methodology developed by the Project for Public Spaces (2020), the elements associated with Access and Linkages, Comfort and Image, Uses and Activities, and Sociability were evaluated, using performance indicators and an index. The results show in general an excellent degree of adequacy of the physical aspects; however, the accessibility indicator was considered unsatisfactory. Accessibility problems impact the use of the park by people with motor disabilities or reduced mobility. Some weaknesses identified in the park can subsidize future design interventions and serve as a parameter for the development of projects in other parks.

Perception of health professionals regarding the use of horticultural therapy

In some countries, such as Croatia, horticultural therapy (HT) is still in its early stages, which is reflected in the extremely low use of this therapy in practice. The main reasons for this are the lack of necessary infrastructure (outdoor or indoor spaces for horticultural activities) and formal education that would allow HT to be carried out safely. The aim of the research was to determine the awareness and perception of the staff of the Special Hospital for the Protection of Children with Neurodevelopmental and Motor Disabilities in Zagreb about the benefits and possibilities of introducing HT into regular therapeutic activities. The research was conducted in 2019 by means of a survey among members of the reference population, i.e., a sample of 120 health workers of the referred hospital. The results show that most respondents are familiar with the concept of horticultural therapy, while as many as 88 % of respondents believe that horticultural therapy is not or is insufficiently known in their environment. Most of the respondents do not recommend HT to their patients. Additional training in HT is considered important or very important by almost all respondents, regardless of where such training would take place. At the same time, 89 % of respondents believe that additional training and the use of HT would significantly improve the overall psychophysical condition of patients and stimulate more competition among colleagues which will lead to a broader application of horticultural therapy. The results show that healthcare professionals are interested in HT in healthcare facilities and are willing to be trained in its safe use.

Effects of Normalized Short-Term Conversations on Individuals with Severe Motor and Intellectual Disabilities: A Heart Rate Study

Effects of Normalized Short-Term Conversations on Individuals with Severe Motor and Intellectual Disabilities: A Heart Rate Study

Vitamin D Supplementation at a Dose of 10 µg/Day in Institutionalized Children with Severe Motor and Intellectual Disabilities.

Vitamin D (VD) deficiency can lead to health-related consequences. This study determined the effects of VD administration in VD-deficient children with severe motor and intellectual disabilities (SMID). Twenty-eight subjects were included. Among them, 25 subjects with parental consent for VD administration were given 10 µg/day (400 IU/day) of VD in April 2021. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured at least 30 days after the start of VD administration. The total VD intake, serum 25(OH)D levels, and ultraviolet (UV) exposure before the blood tests were investigated. The results showed that the median serum 25(OH)D levels were 8.7 ng/mL (4.3-17.2) and 24.0 ng/mL (7.8-39 ng/mL) from March to May in 2020 and 2021, respectively. Among the 25 subjects, 22 with UV exposure had >20 ng/mL serum 25(OH)D level, and 2 without UV exposure had <20 ng/mL serum 25(OH)D level. Three subjects who did not receive VD supplementation had <20 ng/mL serum 25(OH)D level. Taken together, VD supplementation (10 µg/day) is effective in children with SMID in institutional care. Moreover, it may be sufficient for children with UV exposure, but not for those without.

The impact of an aerobic exercise rehabilitation program on stroke patients' ability to walk more comfortably and some physiological indicators

Since stroke is the third leading cause of mortality worldwide, numerous studies must be done to attempt and determine what causes it, how to diagnose it quickly, and how to treat it properly to prevent advanced stages or total disability. The list of most frequent neurological system injuries includes stroke, which leaves victims with motor disabilities. Walking is one of the most frequently used motor skills since it is so integral to daily living, and a stroke frequently results in issues with how the body moves generally, such as the ability to walk. As we know, physical exercises, including aerobic exercises, are nothing more than operations to subject the vital systems of the body under the influence of physical exercises that lead to the occurrence of physiological and morphological changes that result in an increase in body efficiency and his ability. The injured person is treated by taking care of the manifestations of weakness of some muscles, ligaments, and joints. The current study sought to determine how an aerobic exercise-based rehabilitation program affected stroke patients' ability to walk and several physiological parameters. The study's findings showed that the rehabilitation program using aerobic exercises affects the improvement of walking skill and some physiological variables among stroke patients. The researchers used the experimental approach in a one group design, and the sample size was ten patients with stroke who were referred to a physiotherapy center in Koya city.

The Teleton Integrated Care Approach to Deliver Rehabilitation Services and Promoting Inclusion for Children and Teenagers with Motor Disabilities in Chile - Implementation and lessons learned.

People with disabilities face significant barriers in order to get proper access to health care. According to the World Health Organization, they are three times more likely to be denied health care, four times more likely to be treated badly in the healthcare system and 50% more likely to suffer catastrophic health expenditure.&#x0D; In Chile, 5,8% of the children and teenagers have some form of disability. Motor disabilities are one of the most prevalent in this age group. &#x0D; Teleton is a non-profit network of 14 healthcare institutes providing rehabilitation care to 93,5% of children and teenagers with motor disabilities in Chile.&#x0D; Conditions treated by Teleton include Cerebral Palsy, amputations, central nervous system diseases, neuromuscular diseases and other congenital or acquired diseases leading to a motor impairment.&#x0D; Established in 1979 and mostly financed through a yearly national fundraising campaign, over the last 10 years Teleton has faced difficulties to provide adequate coverage and continuity of care to their patients. &#x0D; As a response to these challenges, in 2015 Teleton developed an integrated multidisciplinary model of care including interventions from several specialties such as: physiatry, orthopedics, nursing, physiotherapy, occupational therapy, psychology, education, social work, art therapy, phono audiology and adapted sports therapy. The model follows the principles of the McColl Chronic Model of care.&#x0D; As a core element, the model establishes the creation of specialized multidisciplinary teams of professionals taking care of a specific population from a diagnostic group. This feature allows the workforce to gain expertise and enhance coordination, thus improving the quality of care. &#x0D; Similarly, the model allow patients to be treated by the same professionals who know their clinic history facilitating the delivery of care and patient satisfaction.&#x0D; The aim of this paper is to explain the key components of this model including clinical processes, organization of delivery of care, clinical metrics, team coordination practices, and to present main results in terms of health coverage, health quality, administrative performance, governance and impact on patient functionality.

Neuroprotective role of FOXA1 in Parkinson's disease: Involvements of NF1 transcription activation and MAPK signaling pathway inhibition

Forkhead box A1 (FOXA1), a member of the forkhead family of transcription factors, plays a crucial role in the development of various organ systems and exhibits neuroprotective properties. This study aims to investigate the effect of FOXA1 on Parkinson's disease (PD) and unravel the underlying mechanism. Transcriptome analysis of PD was conducted using three GEO datasets to identify aberrantly expressed genes. A mouse model of PD was generated by injecting neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP), resulting in reduced FOXA1 expression. FOXA1 decline was also observed in 1-methyl-4-phenylpyridinium-treated SH-SY5Y cells. Artificial upregulation of FOXA1 improved motor abilities of mice according to rotarod and pole tests, and it mitigated tissue damage, cell loss, and neuronal damage in the mouse substantia nigra or in vitro. FOXA1 was found to bind to the neurofibromin 1 (NF1) promoter, thereby inducing its transcription and inactivating the mitogen-activated protein kinase (MAPK) signaling pathway. Further experimentation revealed that silencing NF1 in mice or SH-SY5Y cells counteracted the neuroprotective effects of FOXA1. In conclusion, this research suggests that FOXA1 activates NF1 transcription and inactivates the MAPK signaling pathway, ultimately ameliorating neuronal damage and motor disability in PD. The findings may offer novel ideas in the field of PD management.

Successful Correction by Prime Editing of a Mutation in the RYR1 Gene Responsible for a Myopathy.

We report the first correction from prime editing a mutation in the RYR1 gene, paving the way to gene therapies for RYR1-related myopathies. The RYR1 gene codes for a calcium channel named Ryanodine receptor 1, which is expressed in skeletal muscle fibers. The failure of this channel causes muscle weakness in patients, which leads to motor disabilities. Currently, there are no effective treatments for these diseases, which are mainly caused by point mutations. Prime editing allows for the modification of precise nucleotides in the DNA. Our results showed a 59% correction rate of the T4709M mutation in the RYR1 gene in human myoblasts by RNA delivery of the prime editing components. It is to be noted that T4709M is recessive and, thus, persons having a heterozygous mutation are healthy. These results are the first demonstration that correcting mutations in the RYR1 gene is possible.

Impact of mother's care burden, fatigue and child's functional level on quality of life in spastic cerebral palsy.

Cerebral palsy (CP) may be considered one of the most common motor disabilities that require a lot of caregiving from mothers or caregivers; therefore, the mothers of children with CP face a lot of difficulties in their caregiving, which in turn may affect the child's quality of life (QOL). This work was conducted to evaluate the impact of the children's functional level in different types of spastic CP, mothers' care burden (CB), and fatigue on the child's QOL. One hundred thirty-eight children with different types of spastic CP (unilateral and bilateral) with different levels of the gross motor function classification system (GMFCS), with an age range of 6-12years, and their mothers with ages ranged from 25 to 45years, participated in this study. Mother CB, fatigue, and child QOL were measured and compared between different groups by using the Zarit burden Interview (ZBI), Chalder Fatigue Questionnaire (CFQ), and Pediatric Quality of Life Inventory (PedsQL) CP Module, respectively. There were significant differences in all measured variables (ZBI, CFQ, GMFCS, and PedsQL) with p-value <0.001 among the different spastic groups (unilateral and bilateral CP). However, the results revealed a positive impact of the child's GMFCS, mother's CB, and fatigue level on the quality of the child's life, with a greater effect on those with quadriplegic type. The mother's CB and fatigue should be considered in the rehabilitation of spastic CP children based on their GMFCS, as they have a negative impact on child QOL; therefore, helping the mother with her needs should not be ignored, especially in families with severely spastic CP children and low financial income.