Relationship among four functional classification systems and parent interpredicted intelligence level in children with different clinical types of cerebral palsy

To investigate the relationships between four functional classification systems in children with cerebral palsy (CP) and parent-interpredicted intelligence level, and the functional status in clinical types of CP. Two hundred and twenty-five children with CP ages between 2 and 18 (mean age 6.5 ± 4.4) years included using the Surveillance of CP in Europe (SCPE) database in Turkey. Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS) and Eating and Drinking Classification System (EDACS) levels were classified by clinical observation, and intelligence quotient (IQ) was determined by parent reports. Correlations were found between all functional levels; the strongest were between GMFCS-MACS (r = 0.784, p < .001), CFCS-EDACS (r = 0.772, p < .001). Strong correlations were found for the IQ-CFCS (r = 0.762, p < .001) and IQ-EDACS (r = 0.634, p < .001). Correlations were stronger in children with bilateral CP and IQ level <70. Taken together, these four classification systems and reported IQ levels can adequately describe overall functioning for children with CP. Our results can guide clinicians in the rehabilitation of children with CP.

本研究旨在探讨脑性瘫痪（cerebral palsy, CP）儿童的四类功能分类系统与家长报告的智力水平，以及脑性瘫痪临床分型中的功能状态之间的关联。研究纳入了土耳其依托欧洲脑性瘫痪监测（Surveillance of CP in Europe, SCPE）数据库筛选的225名2至18岁脑性瘫痪儿童，其平均年龄为6.5±4.4岁。研究人员通过临床观察对所有受试者进行粗大运动功能分级系统（Gross Motor Function Classification System, GMFCS）、手功能分级系统（Manual Ability Classification System, MACS）、沟通功能分级系统（Communication Function Classification System, CFCS）以及进食与饮水功能分级系统（Eating and Drinking Classification System, EDACS）的等级评定，并通过家长报告获取智商（intelligence quotient, IQ）数据。所有功能分级之间均存在显著关联，其中关联强度最高的为GMFCS与MACS（r=0.784，p<0.001）以及CFCS与EDACS（r=0.772，p<0.001）；智商与CFCS（r=0.762，p<0.001）、智商与EDACS（r=0.634，p<0.001）之间亦存在较强关联。在双侧脑性瘫痪儿童以及智商低于70的儿童中，上述关联强度更高。综上，这四类分级系统与家长报告的智商水平可充分描述脑性瘫痪儿童的整体功能状态。本研究结果可为临床医师开展脑性瘫痪儿童的康复工作提供指导。