Predictors of Gross Motor Function Level in Spastic Type Cerebral Palsy: a Retrospective Study

Abstract

Purpose: This study was conducted to identify the determinants of gross motor function in patients with spastic-type Cerebral Palsy (CP) who received physiotherapy from a single center for two years. Methods: One hundred and eight children with spastic-type CP (mean age: 6.43 +/- 4.83 years) were evaluated twice, before and after the two-year physiotherapy. The outcomes were the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). Binary logistic regression analysis was used to determine whether factors such as age, sex, topographical distribution, and levels of GMFCS, MACS, CFCS, and EDACS could predict the improvement in GMFCS level after the two-year physiotherapy. Results: The odds ratio of improvement in GMFCS level was found to vary significantly with the topographical distribution, CFCS level, and EDACS level (p<0.05). Compared to the children with CFCS Level I, children with CFCS Level II, Level III, and Level IV were 0.001, 0.005, and 0.006 times less likely to improve in GMFCS level, respectively. Similarly, children with EDACS Level III and Level IV were respectively 1.605 and 1.548 times less likely to improve in GMFCS level compared to those with Level I. Conclusion: CFCS and EDACS were significant predictors of gross motor function level in spastic- type CP. Healthcare professionals can use CFCS and EDACS to predict the progression of gross motor function levels, thereby providing more appropriate interventions and more realistic predictions.