Jimmy Chong

Children’s perceptions of their cerebral palsy and their impact on life satisfaction

Purpose: To assess an individual child’s cognitive and emotional perceptions of their cerebral palsy (CP) and how these are associated with their reported life satisfaction and their functional walking ability.Method: Convenience sample of 48 children with cerebral palsy, GMFCS (Gross Motor Function Classification System) I-IV, mean age of 12.2 ± 2.5 years was recruited from tertiary level out-patient clinics. All children completed the Brief Illness Perception Questionnaire-Cerebral Palsy version (BIPQ–CP), Students’ Life Satisfaction Scale (SLSS) and 1- and 6-min walk tests.Results: Children with CP reported levels of global life satisfaction (mean score 31.4/42) equivalent to previous studies of typically developing children. Higher total SLSS scores were associated with lower concern about CP (rho = −0.61, p < 0.001), lower emotional impact (rho = −0.58, p < 0.001), fewer perceived consequences (rho = −0.53, p < 0.001) and perceptions of higher levels of personal control (rho = 0.40, p = 0.01). Multiple regression models using BIPQ-CP constructs found that a combination of lower level of concern and fewer perceived consequences predicted 46% of the variance in SLSS score (p < 0.001). GMFCS levels, walk distance and age were not significant predictors of life satisfaction. Conclusions: Life satisfaction in this group of children was strongly associated with a child’s perceptions of their CP but was not associated with functional walking ability. Although the cross-sectional nature of the study precludes assumptions of causality, understanding children’s cognitive and emotional beliefs about their cerebral palsy would seem to be an important adjunct to clinical management. Implications for Rehabilitation Children with cerebral palsy as young as eight years can self-report cognitive and emotional beliefs about their condition. The reported degree of concern about cerebral palsy is the strongest predictor of the child’s reported level of life satisfaction. Those children with cerebral palsy who do report high levels of concern about their condition also report that they have feelings of reduced personal control and are more affected emotionally, suggesting possible targets for intervention.

Relationship between walk tests and parental reports of walking abilities in children With cerebral palsy

OBJECTIVES To test the strength of association between 2 clinic-based measures of walking ability, the 1-minute walk test (1MWT) and the six-minute walk test (6MWT), and the parental report of usual walking performance, measured by the ABILOCO-Kids logit score, in children with cerebral palsy (CP). DESIGN Observational study. SETTING Tertiary level outpatient clinics. PARTICIPANTS Children and youth with CP (N=60; 32 boys, 28 girls; mean age, 11.2y [range, 5-18y]), Gross Motor Function Classification System (GMFCS) level I to IV. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The 10-item ABILOCO-Kids questionnaire, the 1MWT, and the 6MWT. RESULTS ABILOCO-Kids logit scores were significantly correlated with the 1MWT (ρ=.70, P<.01) and the 6MWT (ρ=.70, P<.01) but not with age or sex. Linear models revealed a possibly significant difference in the strength of the relationship of the ABILOCO-Kids logit score with walking distance, depending on GMFCS level (P=.06 1MWT; P=.14 6MWT). The strongest relationship was observed at GMFCS level II, where ABILOCO-Kids score predicted 33% of variance in 1MWT (P=.003) and 31% of 6MWT (P=.003). The weakest relationship was at GMFCS level I, where ABILOCO-Kids score predicted only 5% of the variance in 1MWT (P=.33) and 16% of the variance in 6MWT (P=.08). CONCLUSIONS Parental perceptions of their childs walking ability in the community correlate with clinic-based walking tests in ambulatory children with CP, providing evidence of convergent validity for the 1MWT and 6MWT. However, parents report a much wider range of walking abilities in children who function at a high level (GMFCS I) than is reflected by their walk test results.

Reported outcomes of lower limb orthopaedic surgery in children and adolescents with cerebral palsy: A mapping review

Lower limb surgery is often performed in ambulatory children with cerebral palsy (CP) to improve walking ability. This mapping review reports on outcome measures used in the published literature to assess surgical results, determine range and frequency of use, and map each measure to the International Classification of Functioning, Disability and Health.

Walking drawings and walking ability in children with cerebral palsy.

OBJECTIVES To investigate whether drawings of the self walking by children with cerebral palsy (CP) were associated with walking ability and illness perceptions. METHOD This was an exploratory study in 52 children with CP (M:F = 28:24), mean age 11.1 years (range 5-18), who were attending tertiary level outpatient clinics. Children were asked to draw a picture of themselves walking. Drawing size and content was used to investigate associations with clinical walk tests and childrens own perceptions of their CP assessed using a CP version of the Brief Illness Perception Questionnaire. RESULTS Larger drawings of the self were associated with less distance traveled, higher emotional responses to CP, and lower perceptions of pain or discomfort, independent of age. A larger self-to-overall drawing height ratio was related to walking less distance. Drawings of the self confined within buildings and the absence of other figures were also associated with reduced walking ability. CONCLUSION Drawing size and content can reflect walking ability, as well as symptom perceptions and distress. Drawings may be useful for clinicians to use with children with cerebral palsy to aid discussion about their condition.