Episode 249 (Elizabeth Maus - PhD Candidate)

Mobility device use in children with cerebral palsy

Elizabeth Maus, Ben Reader, Jill C Heathcock

Abstract

Aims: To quantify the number and types of mobility devices used by children with cerebral palsy (CP) and explore the relationships between Gross Motor Functional Classification System (GMFCS) level, age, insurance, income, and number and types of devices.

Method: This was a secondary analysis of a cohort from a larger randomized controlled trial. Data from 89 children with CP (56.2% male and 43.8% female; mean = 4 years 11 months; SD = 2 years 0 months; range 2 years 0 months-8 years 10 months) were collected from electronic medical records, parent-completed medical history questionnaires, and the Hollingshead Four-Factor Index. The analysis included quasi-Poisson and logistical regressions.

Results: Most children had Medicaid insurance (83.2%). All income and GMFCS levels were represented. The most common mobility devices were lower-extremity orthoses (75.3%). The number of devices used increased by 8.2% for each 1-year increase in age. Children classified in GMFCS level V used 5.1, 2.9, and 1.6 times more mobility devices than children classified in GMFCS levels I, II, and III respectively. GMFCS level also predicted the use of wheelchairs, bath chairs, and standers. Income and insurance were not significant.

Interpretation: Children used more devices as age and GMFCS level increased. Device access is an important public health initiative.