Impact of Environment on Motor Function and Methods of Mobility in Children with Cerebral Palsy: A Cross-sectional Study

Abstract

Introduction: Activities of Daily Living (ADL) in children with Cerebral Palsy (CP) include a variety of environmental settings. Environmental setting plays an important role in clinical assessment and therapeutic intervention to improve the mobility in children with CP. There are various environmental factors like movable surfaces, stairs, carpeting, physical obstacles, which facilitate or constrain the mobility of children with CP. Aim: To study the differences in motor function and gait speed at different environmental settings and find out the usual mobility methods of children with CP in home, school and community settings. Materials and Methods: A cross-sectional study was conducted in the Outpatient Department (OPD) of Paediatrics at Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India. The duration of the study was seven months, from February 2022 to August 2022. A total of 50 CP children aged between 4-12 years were included and demographic details were collected. Type of CP, gross motor function, gait speed and methods of mobility were evaluated at home, community and school in all the children with CP. Gross Motor Function Measurement (GMFM 88-E), One-Minute Walk Test (1MWT) and parent checklist for mobility methods were used as outcome measures to collect the data and analysed with Wilcoxon signed-rank test and Friedman test. Results: The mean age of the study population was 8.34±1.62 years, which included 29 (58%) male children and 21 (42%) female children. Gross motor function and gait speed varied across the environment and statistically significant differences (p-value=<0.001) were observed in the home, community and school. Results related to methods of mobility showed that, most of the children, 38 (76%) walk alone in the home and are carried by adults in the community 30 (60%) and use all mobility methods in school. Conclusion: The present study concluded that, the gross motor function, gait speed and methods of mobility varied across the different environmental settings (home, community and school). Motor function and gait speed were better at home, followed by the school than the community. The common method of mobility was walking alone at home and being carried by adults in the community