Lower limb functioning and its impact on quality of life in ambulatory children with cerebral palsy

Background: Children with cerebral palsy (CP) are confronted on a daily basis with their motor problems affecting gait, which might impact on their quality of life (QOL). Aim: The goal of this study was to evaluate the impact of gross motor and gait function on QOL in ambulatory children with CP attending regular school. Methods: A condition-specific questionnaire (CP QOL-Child), including a parent/proxy and child self-report, was used to assess the relation between patient characteristics, lower limb impairments and functioning, and the different aspects of the child's QOL. Data on therapy management, lower limb impairments, and gross motor and gait function was collected for 81 children with CP (10.5 +/- 3.0 years). CP QOL-Child questionnaires were completed by a parent/proxy for all 81 children and by 39 of the children over 9 years. Results: The mean self-reported QOL score (78.2 +/- 9.6) was significantly higher than the mean parent/proxy reported score (73.9 +/- 10.2). Lower limb spasticity and higher frequency of BTX-A injections correlated with worse scores for the pain and impact of disability domain. Results further showed the adverse impact of the severity of gait pathology on QOL perception for the parents/proxy and the child self-report. Gait speed was an important factor for the parents/proxy, though correlated less with self-perceived QOL for the children. Conclusions: Children and parents identified similar factors that adversely affect QOL, whereby the amount of gait pathology was shown to play a crucial role. Only gait speed seemed to be of higher importance for the parents compared to the children. (C) 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.