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The Relationships Between Capacity and Performance in Youths With Cerebral Palsy Differ for GMFCS Levels

Ho, Pei-Chi MSc; Chang, Chia-Hsieh MD; Granlund, Mats PhD; Hwang, Ai-Wen PT, PhD

doi: 10.1097/PEP.0000000000000332
Research Reports

Purpose: To examine change in, and longitudinal relationships between motor capacity and activity performance across the Gross Motor Function Classification System (GMFCS).

Methods: Ninety-two youths with cerebral palsy were examined at 2 time points, 1 year apart, using the Gross Motor Function Measure–66 (GMFM-66) for motor capacity, and the Chinese version of the Activities Scale for Kids-Performance Version (ASKp-C) for activity performance. The score changes and capacity-to-performance/performance-to-capacity pathways were explored across GMFCS levels.

Results: The GMFM-66 scores declined over time in GMFCS levels IV-V while ASKp-C scores increased in GMFCS level I. The correlations for both pathways in GMFCS levels I, III, and IV-V were significant with a higher correlation for performance-to-capacity pathway in GMFCS levels IV-V.

Conclusions: Longitudinal changes in and relationships between capacity and performance differ between GMFCS levels. The opportunities to perform activities need to be emphasized in GMFCS levels IV-V.

An examination of change in, and longitudinal relationships between motor capacity and activity performance across the Gross Motor Function Classification System.

Department of Pediatric Orthopedics (Ms Ho and Dr Chia-Hsieh Chang), Chang Gung Memorial Hospital, and Graduate Institute of Early Intervention, College of Medicine, Chang Gung University & Department of Physical Medicine and Rehabilitation (Dr Hwang), Chang Gung Memorial Hospital, Linkou, (Dr Hwang), Tao-Yuan, Taiwan; and CHILD (Dr Granlund), Swedish Institute of Disability Research, School of Health Science, Jönköping University, Jönköping, Sweden.

Correspondence: Ai-Wen Hwang, PT, PhD, Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweishan, Taoyuan, Taiwan (awhwang@mail.cgu.edu.tw).

Dr. Chang and Ms. Ho made equal contributions to the manuscript.

Grant support: This study was funded by the National Science Council of Taiwan (No.101-2314-B-182A-004-MY3; NSC 102-2628-B-182-001-MY3).

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.