Cerebral palsy in children- clinical and functional characterization

Abstract

Background: Cerebral palsy, an umbrella designation of a group of permanent and non progressive disorders ofmovement and posture, caused by a cerebral lesion occurred until 5 years-old, is the commonest cause of disabilityin pediatric age. Its repercussions are varied, potentially causing cognitive, motor, postural, sensorial andcommunication changes, and therefore compromise the complete development of the child.

Objective: Characterize the children with cerebral palsy followed in the Pediatric Rehabilitation Consultationregarding epidemiologic, demographic, social and function aspects and describe the most frequent neuroorthopaedicalcomplications in that population.

Methods and Subjects: Retrospective longitudinal study of the children with cerebral palsy followed in PediatricRehabilitation Consultation of the Centro de Medicina de Reabilitação de Alcoitão (CMRA), born between 2001-2005. Data on socio-demographic and clinical aspects were collected from clinical files, and also the scores of theclassification systems used.

Results: Of the 75 children followed, 40% had severe motor and bimanual manipulative ability limitations. 21children (28%) had severe or very severe oromotor changes. One third had severe or very severe changes in thecommunication ability and the majority (67%) had some degree of cognitive affection. 41% of the children hada sensorial deficit (vision and/or hearing).Lower limbs deformities were the most common orthopedic alterations, followed by upper limb deformities andcifoscoliosis. Bilateral spastic patients had the greater number of complications and therefore had more benefitof botulinum toxin administration.40% of these children inward admissions in CMRA were for rehabilitation after orthopedic surgery such asAchilles lengthening (50 %), hip varus derotation (34 %) and adductors tenotomy (16%).

Conclusions: Stablishing the functional profile of children and teenagers with cerebral palsy is determinant toidentify and characterize the population followed in a Consultation, in a easy and rapid way. In order to achieveit, there are several standardized classification systems. The acknowledgement of the most frequent clinical casesallows the definition of therapeutic strategies, resource necessities in short and long-term periods, social andschool supports, besides preventing/delaying the onset of possible complications.

Keywords: Cerebral Palsy; Child; Motor Skills.