The Effect of Foot-Ankle Condition On Physical Performance in Cerebral Palsy With Spastic Equinus Deformity.

Abstract

Background: The severity of foot disability in children with cerebral palsy (CP) should be examined with both objective and subjective assessment tools. This cross-sectional study investigated the effect of foot-ankle function on physical performance in CP with spastic equinus deformity.

Methods: A cross-sectional prospective study was performed on 61 children with cerebral palsy. Participants were evaluated by Gross Motor Function Classification System (GMFCS), Oxford Ankle Foot Questionnaire for Children (OxAFQ-C), Timed Up and Go Test (TUG), Single Leg Stance Test (SLST), 3-Meter Backward Walking Test (3MBWT) and Functional Reach Test (FRT).

Results: The mean age of the children with CP (28 female, 33 male) included in the study was 11.3±4.4 years. Individuals with higher ankle-foot function had better TUG, 3MBWT, and SLST performances (p<0.005). OxAFQ-C physical scale was moderately correlated with TUG (r=-0.474) and SLST (right extremity-eyes open) (r=0.386) (p<0.01). In addition, there was a low significant correlation between 3MBWT, SLST (right extremity-eyes closed), SLST (left extremity-eyes open), and SLST (left extremity-eyes closed) with OxAFQ-C physical scale (p<0.05). OxAFQ-C school and play scale had a moderate to weak correlation coefficient (r=0.257-0.430) with all physical performance tests (p<0.05). In addition, there were moderate and low correlations between OxAFQ-C emotional scale with TUG (r=-0.495) and 3MBWT (r=-0.298), respectively.

Conclusion: The results showed that foot-ankle performance influenced physical performance on time-based physical tasks but not better performance-based physical conditions. It was concluded that foot-ankle condition was most strongly associated with sit-to-stand and walking performance.