Participation in Daily Life: Influence on Quality of Life in Ambulatory Children with Cerebral Palsy

Background: Cerebral palsy (CP) is a chronic condition that affects children and has an impact on social and physical activity, as well as participation in daily life. Participation and quality of life (QOL) are 2 important measures of successful rehabilitation that have not been well studied in children with CP. Objective: To report levels of participation and examine the relationship of participation to QOL in ambulatory children with CP. Design: Secondary analysis, cross-sectional cohort study. Setting: Regional pediatric specialty care center. Participants: A cohort of 128 ambulatory children with CP, Gross Motor Function Classification System levels I-III, age 2-9 years. Interventions: Not applicable. Main Outcome Measures: Pediatric Quality of Life Inventory; Assessment of Life Habits; and Children's Assessment of Participation and Enjoyment and Assessment of Preschool Children's Participation. Results: Participation was negatively associated with increasing Gross Motor Function Classification System but not age. Level of participation was associated with psychosocial QOL (2.97, P = .001) and total QOL (54.70, P = .03) but not physical QOL. There was a positive relationship between physical activity performance (0.63, P = .001), walking performance (0.002, P = .01), and communication level (7.23, P = .05) with physical QOL. Increasing age and decreased frequency of participation were negatively associated with all QOL domains. Conclusions: The results suggest that participation in daily life is negatively influenced by physical impairment and that levels of participation are positively associated with psychosocial and total QOL among ambulatory children with CP. This suggests that participation influences QOL and further studies are needed to determine the aspects of participation directly impacting QOL in ambulatory children with CP.