Variability in Mobility of Children with Cerebral Palsy

PURPOSE: To examine the variability in mobility of children with cerebral palsy (CP) within classification levels. METHODS: The subjects were 183 children with CP, ages six to 12 years, at Gross Motor Function Classification System (GMFCS) levels II to IV. Parents reported their child's mobility methods in the home, school, and outdoors/community. Mobility methods were ranked using empirical data and reflect trunk and lower extremity motor control requirements. These ranks were used for Friedman analysis of variance and post-hoc analyses for each GMFCS level. RESULTS: Children within the same GMFCS level exhibited varying degrees of independence in mobility methods, which differed across setting. Children usually performed higher-ranked mobility methods (requiring the most gross motor control) at home, lower-ranked mobility methods at school, and the lowest ranked mobility methods in the outdoors/community. CONCLUSIONS: Contextual, environmental, and personal factors may explain these findings. Therapists are encouraged to examine contextual features in everyday settings when planning interventions to improve functional mobility.