Comparing functional profiles of children with hemiplegic and diplegic cerebral palsy in GMFCS Levels I and II: Are separate classifications needed?

Diane Damiano, Mark Abel, Mark Romness, Donna Oeffinger, Chester Tylkowski, George Gorton, Anita Bagley, Diane Nicholson, Douglas Barnes, Janine Calmes, Richard Kryscio, Sarah Rogers

Research output: Contribution to journalArticlepeer-review

68 Scopus citations

Abstract

The goal was to compare children with hemiplegia with those with diplegia within Gross Motor Functional Classification System (GMFCS) levels using multiple validated outcome tools. Specifically, we proposed that children with hemiplegia would have better gait and gross motor function within levels while upper extremity function would be poorer. Data were collected on 422 ambulatory children with cerebral palsy: 261 with diplegia and 161 with hemiplegia, across seven centers. Those with hemiplegia in each level performed significantly and consistently better on gait or lower extremity function and poorer on upper extremity and school function than those with diplegia. In GMFCS Level II, the group with hemiplegia walked faster (p=0.017), scored 6.6 points higher on Dimension E of the Gross Motor Function Measure (p=0.017), 6.7 points lower on Upper Extremity subscale of the Pediatric Outcomes Data Collection Instrument, and 9.1 points lower on WeeFIM self-care (p=0.002). Basing motor prognosis on GMFCS level alone may underestimate lower extremity skills of children with hemiplegia, and overestimate those of children with diplegia.

Original languageEnglish
Pages (from-to)797-803
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Volume48
Issue number10
DOIs
StatePublished - Oct 2006

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

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