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Dissertation
Usual mobility methods of children with cerebral palsy: a comparison across home, school, and outdoors/comunity settings
Doctor of Philosophy (Ph.D.), Medical College of Pennsylvania and Hahnemann University
May 2002
DOI:
https://doi.org/10.17918/00008576
Abstract
The purpose of this dissertation was to examine usual mobility methods of children with cerebral palsy (CP) in the home, school, and outdoors/community settings. Mobility is needed in activities of daily living and limitations in mobility may impact participation in society. Even though interventions are often provided in natural environments, knowledge of the impact of environmental setting on mobility is limited. The subjects were 307 children with CP, ages 6-14 years who participated in a longitudinal study, randomly selected from 19 centers, and stratified by age and Gross Motor Function Classification System (GANEFS) level. Measures included the GANEFS, parent-completed questionnaire on children's usual mobility methods, and the Gross Motor Function Measure. The first study indicated differences in gross motor capability and parent report of performance of mobility methods in children with CP. Among children with CP who have similar capability, there were differences in performance across settings. The second study demonstrated among children within the same GANEFS level, the variability of mobility methods across settings. Children performed higher-ranked mobility methods at home (requiring the most gross motor control), lower-ranked mobility methods at school, and the lowest-ranked mobility methods (requiring the least gross motor control) in the outdoors/community. The third study provides evidence for nonlinear changes in mobility over time in children with CP. During the first 1 1/2-2 1/2 years, mobility methods increased to higher-ranked methods, while in the second 1 1/2-2 years, mobility methods were unchanged or decreased to lower-ranked methods. The changes in mobility methods over time did not differ across settings. The findings indicate that environmental setting has an impact on the usual mobility methods of children with CP. The examination of children with CP should include capability and/or performance measures, depending on the purposes of examination. Performance should be measured specific to settings where children function, including the contextual features and personal factors that may influence mobility. Intervention should address the factors contributing to mobility, such as environmental adaptations and child-related factors. Screening of children with CP should occur at regular intervals so that interventions can address the changes in mobility.
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Details
- Title
- Usual mobility methods of children with cerebral palsy
- Creators
- Beth Tieman
- Contributors
- Robert J. Palisano (Advisor) - Drexel University, Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002)
- Awarding Institution
- Medical College of Pennsylvania and Hahnemann University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Medical College of Pennsylvania and Hahnemann University; Philadelphia, Pennsylvania
- Number of pages
- x, 129 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002); Rehabilitation Sciences/Physical Therapy [Historical]; College of Nursing and Health Professions (2000-2002)
- Other Identifier
- 991021888874704721