The Relationship Between The Levels Of Gross Motor Function Classification System and Treatment Methods in Children With Cerebral Palsy
2 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye DOI : 10.5152/tftrd.2015.09069
Objective: First aim was to investigate the relationship between the levels of Gross Motor Function Classification System (GMFCS) and treatment methods in children with cerebral palsy(CP). The second purpose was to evaluate the distribution of the treatment methods according to GMFCS levels, and compare with the European Consensus of botulinum toxin (Btx) use treatment methods- gross motor function graphs.
Material and Methods: The files of 187 children with CP who were hospitalized in our pediatric rehabilitation unit were recorded. Demographical characteristics and therapies (physical theraphy and rehabilitation, orthotics, oral antispastic treatment, botulinum toxin, orthopedic surgery) of children with CP were recorded. GMFCS was used to determine severity of CP.
Results: Total of 187(108 male 79 female) children included. The mean age of the patients was 7.01±3.0 years. According to GMFCS Levels; most of the patients were at level 3(29.4%) and level 4(29.9%). all of the patients had physical theraphy and rehabilitation programme. According to GMFCS levels use of orhthosis was highest at level 2(71.4%) and level 3 (43.6%), the use of antispasticity medicine was highest at level 3(27.3%) and 4(25%), Btx application was highest at level 1(66.7%) and 3 (74.5%), orthopedic surgery was highest at level 3(27.3%) and 4(28.6%). Statistically significant difference was detected between AFO use (p=0.001) and Btx (p=0.001) according to GMFCS levels but not in terms of oral antispastic treatment (p=0.28) and orthopedic surgery (p=0.10). We observed that the distrubition of the usage of oral antispastic drugs, physical therapy and rehabilitation, Btx, which are the treatments we applied were compatible with the theraphy recommendations which take place in European Consensus Report.
Conclusion: Rehabilitation of children with CP requires a multidisciplinary approach. Severity of CP should be considered when establishing the treatment plan. Our results will be helpful to explain the multidisciplinary treatment to families of children with CP.