Relationship between gross motor function and the function, activity and participation components of the International Classification of Functioning in children with spastic cerebral palsy.
Byoung-Hee Lee
PMID 29184279WHAT IT FOUND
In children with spastic cerebral palsy, ICF Activity and Participation scores were related to GMFM, GMFCS, MACS, WeeFIM, and ICF Function scores.
This is an association, not proof that training improves participation.
Key findings
01The ICF Activity and Participation score was strongly correlated with GMFM (r=-0.737), GMFCS (r=0.711), MACS (r=0.699), WeeFIM (r=-0.838), and ICF Function (r=0.882), all p<0.01.
02Children with hemiplegic CP had higher GMFM and WeeFIM scores than children with diplegic or quadriplegic CP, and children with diplegic CP had higher scores than children with quadriplegic CP.
03GMFM, WeeFIM, ICF Function, and ICF Activity and Participation scores differed significantly among mild, moderate, and severe MACS groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is an observational association study, so it cannot show that improving gross motor or hand function causes better activity or participation. The paper does not report a single pre-specified primary outcome; the main results are group comparisons and correlations. The direction of ICF Function and Activity/Participation scores is unclear because the text says hemiplegic children had higher scores, but Table 1 shows lower values for hemiplegia than diplegia and quadriplegia. The supplied text does not describe blinding of assessors or independent rating, and some severity groups were small. The supplied text does not include a funding or conflict of interest declaration.
The easy way to misread this
Do not conclude that therapy for gross motor function will improve activity and participation. This study only measured associations in children with spastic cerebral palsy, and it did not test an intervention.