RELATIONSHIP BETWEEN CAPABILITY AND PERFORMANCE IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY IN THE FEDERAL DISTRICT

Abstract

Background

The child with Cerebral Palsy (CP) presents different ways of locomotion which are influenced by the environment and can act as a facilitator or a barrier. According to the International Classification of Functioning, Disability, and Health (ICF), capacity refers to abilities in a controlled situation and environment and indicates the maximum level of functionality for a given moment, with minimal influence of environmental factors. On the other hand, performance refers to the execution of activities in everyday environments, such as home, school, and community, considering the environment in which the child is inserted. The difference between capacity and performance expresses the impacts of the controlled environment and the customary environment, allowing guidance on what can be modified in the environment to improve performance.

Objectives

To verify the relationship between ability and mobility performance in three different environments in children and adolescents with Cerebral Palsy in the Federal District and surroundings.

Methods

This is a Cross-sectional study. Thirty-eight children, from age 4 to 17 years old (±7.4 years), diagnosed with CP at all five levels of the Gross Motor Function Classification System (GMFCS) were included. Mobility capacity was verified using the Gross Motor Function Measure test score, version 66 (GMFM-66). Performance was evaluated using the Function Mobility Scale (FMS), in the home, school, and community environments, in 8 levels: 6- independent on all surfaces; 5- independent on ground surfaces; 4- uses canes, 3- crutches; 2- walker; 1- wheelchair; N- does not complete the distances; C - crawls. The sample characteristics were analyzed using descriptive statistics. Spearman (r) correlation was performed between GMFM-66 scores and FMS levels in the three environments (home, school, and community). The strengths of the correlations were determined as follows: r=0.00-0.19 very weak correlation, r=0.20-0.39 weak correlation, r=0.40-0.59 moderate correlation, r=0 .60-0.79 strong correlation, r=0.80-1.00 very strong correlation.

Results

38 children with CP participated, 62% male, 76.5% with bilateral impairment, 26.3% GMFCS V, 15.8% GMFCS IV, 10.5% GMFCS III, 26.3 GMFCS II and 21.1% GMFCS I and 84.2% SUS users (Unified Health System). A strong correlation was found between ability and mobility performance at home (R = 0.726; p <0.001), school (R = 0.726; p< 0.001) and community (R = 0.680; p<0.001) environments.

Conclusion

Results of mobility, ability, and performance are strongly correlated in children and adolescents with cerebral palsy aged 4 to 17 years.

Implications

This study demonstrates that children are performing mobility at home, at school, and in the community according to what they are able to accomplish.