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Activity performance and participation of children and adolescents with cerebral palsy: A cross-sectional multicentre study in Brazil
Journal article   Open access   Peer reviewed

Activity performance and participation of children and adolescents with cerebral palsy: A cross-sectional multicentre study in Brazil

Déborah E Fontes, Kênnea M A Ayupe, Paula S C Chagas, Robert J Palisano, Hércules R Leite and Ana Cristina R Camargos
Developmental medicine and child neurology, Forthcoming
15 Jun 2026
PMID: 42298763
url
https://doi.org/10.1111/dmcn.70335View
Published, Version of Record (VoR) Open

Abstract

To evaluate direct, indirect, mediating, and moderating effects on the activity performance and participation of children and adolescents with cerebral palsy (CP), from the perspective of the International Classification of Functioning, Disability and Health (ICF). This cross-sectional study included 190 Brazilian children and adolescents, with a median age of 7 years. The Pediatric Evaluation of Disability Inventory - Computer Adaptive Test was used to evaluate activity performance (daily activities, mobility, social/cognitive domains) and participation (responsibility domain). Data on Gross Motor Function Classification System (GMFCS) level, age, anatomical distribution, and use of assistive technology for mobility (environmental factors) were collected by an online form and included in the structural equation modelling using path analysis. A direct effect was identified from the GMFCS, age, anatomical distribution, and assistive technology for mobility. Anatomical distribution indirectly influenced all domains, with GMFCS level mediating this relationship. The moderating effect of assistive technology for mobility in the GMFCS levels was observed, improving the performance in daily activities, mobility, social/cognitive functioning, and responsibility. This study contributes to the understanding of the complexity of factors influencing the activity performance and participation of children and adolescents with CP, emphasizing the need for comprehensive assessments aligned with the ICF framework.

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