Functional Levels of Children with Cerebral Palsy and Their Association with Family Impact and Maternal Health .

Abstract

Objectives: To examine the relationships between gross motor function, manual ability, and functional independence in children with cerebral palsy (CP), and their associations with maternal health-related quality of life and family impact.

Design: Retrospective cross-sectional chart review with blinded assessment of routinely collected outcome measures.

Materials and methods: Records of 45 children with CP were screened; 23 children aged 4-13 years who met predefined eligibility criteria and their primary caregiver mothers were included in the final analysis. Children's gross motor function, manual ability, and functional independence were assessed using the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Pediatric Functional Independence Measure (WeeFIM). Maternal health-related quality of life and family impact were evaluated using the Nottingham Health Profile (NHP) and Impact on Family Scale (IOFS). Associations were analysed using Spearman correlation and multiple linear regression.

Results: WeeFIM showed a strong positive correlation with IOFS, whereas GMFCS showed a strong negative correlation with IOFS. NHP was negatively correlated with child age and WeeFIM. In multivariable analysis, WeeFIM was the only independent factor associated with IOFS. The correlations of IOFS with child age, maternal age, MACS, and NHP did not reach statistical significance. NHP scores were negatively correlated with child age (ρ = -0.458, p = 0.028) and WeeFIM scores (ρ = -0.535, p = 0.009). In multiple linear regression, WeeFIM remained the only significant independent factor associated with IOFS, explaining 68.6% of the variance in family impact (R² = 0.686, adjusted R² = 0.672).

Conclusion: Greater functional independence in children with CP was associated with more favorable family impact and better maternal health-related quality of life. These findings support family-centred rehabilitation approaches that prioritize daily living skills and systematically address caregiver needs.