A majority of children with cerebral palsy are unable to push themselves using manual wheelchairs, but kids with powered wheelchairs are much more independent, researchers found.
A study published in the journal BMC Pediatrics analyzed the extent that hand function, upper extremity range of motion, and gross motor function affects independent wheelchair mobility, both indoors and out, in children with cerebral palsy (CP).
To better recognize their needs and care requirements, CP patients are classified according to the Gross Motor Function Classification System (GMFCS), which determines the patient’s level of motor function and method of locomotion, and the Manual Ability Classification System (MACS), which classifies how kids with cerebral palsy handle objects in daily life.
The study, “Physical risk factors influencing wheeled mobility in children with cerebral palsy: a cross-sectional study,” collected information from 2,328 children from newborns to age 11 regarding their everyday wheeled mobility performance. Parents reported their children’s abilities to use a wheelchair indoors and outside, both independently or with the help of adults.
The authors found that most of the children were unable to self-propel manual wheelchairs, especially outdoors. This observation was independent of age, gross motor function, upper extremity range of motion, or manual abilities. But children who used powered mobility were more independent, showing only some level of difficulty outside.
“These results provide support for previous studies, showing that power wheelchairs provide independent mobility while manual wheelchairs only facilitate care,” the authors wrote.
According to the team, poor hand function was the greatest risk factor for CP patients being unable to self-propel a manual wheelchair. Stiffness of fingers and wrists and a low level of gross motor function were also identified as risk factors.
And, the more severe cerebral palsy symptoms classifications — GMFCS V or MACS IV-V — were identified as the greatest risk factors for not being able to use a power wheelchair independently.
“Power mobility should be considered at earlier ages to promote independent mobility for all children with CP who require a wheelchair, especially outdoors, to promote independent mobility, activity and participation in the home, school and community,” the authors wrote.
Cerebral palsy refers to a group of neurological disorders that are characterized by alterations in the parts of the brain that control muscle movements. It appears in infancy or early childhood and permanently affects body movement, muscle coordination and body balance.