Indian Journal of Physical Medicine and Rehabilitation

Register      Login

VOLUME 23 , ISSUE 1 ( March, 2012 ) > List of Articles

RESEARCH ARTICLE

Correlation of Gross Motor Function with Topographical Diagnosis in Children with Cerebral Palsy

Nonica Laisram, Tufail Muzaffar, S Y Kothari

Citation Information : Laisram N, Muzaffar T, Kothari SY. Correlation of Gross Motor Function with Topographical Diagnosis in Children with Cerebral Palsy. Indian J Phy Med Rehab 2012; 23 (1):10-14.

DOI: 10.5005/ijopmr-23-1-10

Published Online: 00-03-2012

Copyright Statement:  Copyright © 2012; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

There is a need for appropriate classification to describe gross motor function status in a child with cerebral palsy (CP). It was hypothesised that: greater the number of limbs involved, higher would be the Gross Motor Function Classification System (GMFCS) level; and, there would be spectrum of GMFCS level for each of the topographical types of the cerebral palsy.

A cross-sectional study of 182 children of both sexes in the age group of 7 months to 30 years having spastic CP who attended CP clinic from 2008 to 2009 in tertiary care hospital were assessed for topographical diagnosis and GMFCS levels. Topographical distribution showed diplegia (42%), quadriplegia (30%), hemiplegia (23%), triplegia (4%) and monoplegia (1%). GMFCS levels were almost evenly distributed, level II (26%) was most common followed by level V (23%). Statistical analysis was done using Cramer's ratio and Pearson's Chi-square test.

Cramer's ratio of 0.277 showed fairly weak correlation between GMFCS levels and topographical CP types. Pearson's Chi-square (12) =41.7, p=0.000 indicates that there is significant difference between expected and observed values of number of limbs involved in GMFCS levels, further substantiating the weak correlation.

These results mean that GMFCS in different topographical groups have different distributions. It was also observed that GMFCS had weak correlation with the number of limbs involved, thus reflecting that the GMFCS is a better indicator of gross motor function impairment than the traditional topographical categorisation of CP that specifies the number of limbs involved.


PDF Share
  1. A report: The definition and classification of cerebral palsy. Dev Med Child Neuro 2006;109:8-14.
  2. Cerebral Palsy. [book auth.] Randall L Braddom. Physical medicine and rehabilitation. New Delhi : Elsevier, 2007:1241-67.
  3. Gross motor function classification system expanded and revised. Dev Med Child Neurol 1997;39:214-23.
  4. Cerebral palsy–an etiological study. Indian J Pediatr 1992;59:723-8.
  5. Trends in birth prevalence of cerebral palsy. Arch Dis Child 1987; 62: 379-84.
  6. Case gender and severity in cerebral palsy varies with intrauterine growth. Arch Dis Child 2005;90:474-9.
  7. Cerebral palsy in multiple births in Western Australia: genetic aspects. Am J Med Genet 1990;37:346-51.
  8. Cerebral palsy in Victoria: motor types, topography and gross motor function. J. Paediatr. Child Health 2005;41:479-83.
  9. Characterization of adults with cerebral palsy. Rev Bras Fisioter 2010;14:417-25.
  10. Spectrum of gross motor function in extremely low birth weight children with cerebral palsy at 18 months of age. Pediatrics 2005;116:123-9.
  11. Limb distribution, motor impairment, and functional classification of cerebral palsy. Dev Med Child Neurol 2004;46:461-7.
  12. Use of the GMFCS in infants with CP: the need for reclassificationat age 2 years or older. Dev Med Child Neurol 2008;51:46-52.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.