الفهرس 
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Abstract
The term ”cerebral palsy” is used to describe a group of permanent disorders that have an impact on things like movement, posture, and motor control. In many cases, parents of children with cerebral palsy report that their kid suffers mostly from musculoskeletal pain. The Gross Motor Function categorization System (GMFCS) is a categorization system applied to measure and categorize a child’s level of movement ability. There are several factors that contribute to and shape how well a kid with cerebral palsy (CP) lives. A person’s quality of life can be negatively impacted by the presence of many comorbid conditions and the presence or presence of pain. Children with CP who experience pain have a lower quality of life than those with the same diagnosis who do not.
The purpose of this research is to assess the impact that cerebral palsy (CP) has on the musculoskeletal system and the functional ability of children and adolescents. The study also intends to look at how these variables affect people’s happiness. It is also crucial to investigate the factors that may influence a person’s musculoskeletal discomfort, motor functional status, and quality of life when they have these diseases.
Patients’ medical histories were meticulously recorded, and their physical examinations were exhaustive. Several aspects of the patient’s body were scrutinized during the physical examination: their stride was watched, muscle tone and strength were measured, joint mobility was evaluated, and spinal curvature was spotted. A combination of the Gross Motor Function Classification System (GMFCS) and the Functional Motor Scale (FMS) was used to determine how well a person’s motor skills were functioning. The health-related quality of life was measured using the pediatric Quality of Life Inventory 4.0. The CHQ-PF28 and r=FLACC pain rating measures were used for the assessments. The IQ of the
children was determined by having their parents fill out a questionnaire and by having the kids take the SB-5 test.
One hundred children who were receiving outpatient care from the Rheumatology and Rehabilitation and Pediatric departments were included in the study. These children were diagnosed with cerebral palsy (CP). The results of the investigation can be summed up as follows: Patients in this study overwhelmingly consisted of males (64%), leading to a male to female ratio of 1.8:1. Children as young as half a year old and as old as seventeen were included in the research. Spastic cerebral palsy, which accounted for 57% of all cases, was by far the most common form of the disorder seen. Based on the analysis of associated conditions identified in individuals with cerebral palsy (CP), it was shown that a majority of patients (80%) had musculoskeletal disorders, with Gastrocnemius contracture being the most prevalent condition (65%). Not only did 31% of people with CP have seizures, but 16% complained of pain, 10% had respiratory issues, 8% had gastrointestinal issues, and 5% had vision difficulties.
The SPARCLE study found that 73% of patients with cerebral palsy had cognitive impairment as measured by the impairment form. Additionally, the Stanford Binet 5th edition (SB-5) evaluation demonstrated cognitive impairment in 90.5% of patients. Levels IV and V of gross motor dysfunction (GMD) were found to be present in the majority of patients (67%). A slightly lower percentage of individuals (32%), classified as having level I or II GMD, followed. Level III GMD, the mildest form, was only present in 1% of individuals. GMFCS-E & R was used as the determining factor for these results.
Gross Motor Function Classification System (GMFCS) scores and intellectual disability were found to be moderately positively correlated. Gross motor function impairment was found to vary considerably across spasticity types.
The Gross Motor Function Classification System (GMFCS) and the ability to walk were found to have inverse relationships with the Functional Mobility Scale (FMS). In contrast, a moderate positive correlation was found between the FMS and the MRC scale, indicating that children with severe cerebral palsy (GMFCS IV and V) and reduced muscle strength have limited functional mobility. The outcomes of our analysis demonstrated a statistically significant positive correlation between the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS).
There was a negative association identified between the age of individuals diagnosed with cerebral palsy (CP) and their scores on the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). The Functional Mobility Scale (FMS) scores, on the other hand, increased with age. The present analysis demonstrated a substantial connection between the severity of motor impairment and pain. Increasing levels of impairment are connected with more occurrences of spasticity, which in turn leads to the perception of pain, suggesting a probable causal linkage between the two.
The findings of this study reveal that musculoskeletal illnesses have a detrimental effect on quality of life, notably in the areas of physical well-being, academic performance, and emotional well-being. Additionally, musculoskeletal disorders were identified as the leading cause of pain, with research indicating that this suffering has a negative impact on both physical and social elements of people’s lives. The older the patient, the better their quality of life was found to be in all aspects of health and functioning, including physical health, mental health, social health, and psychological health. A decrease in quality of life was observed, especially in the areas of physical health, social relationships, and mental health, in correlation with the severity of cognitive decline. When comparing the severity of
motor impairment using the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS), there is a positive link between the severity of motor impairment and the degree to which limitations are experienced in ADLs. This connection is a significant contributing factor to the overall lower quality of life, notably in the physical, social, school, and psychosocial domains.
Quality of life (QoL) was predicted by participants’ mobility, the Manual Ability Classification System (MACS), and the level of patient knowledge. There was a statistically significant positive association between the physical domain of QoL and ambulation, patient education, and higher levels of manual ability.
Children with Cerebral Palsy and their families face challenges that affect their health and well-being. Age, physical independence, mobility, intellectual disability, pain, and muscle strength are all positively correlated with the PedsQL
0.4 score. Health-related quality of life (HRQOL) in children with Cerebral Palsy (CP) can be accurately measured with the help of the Gross Motor Function Classification System (GMFCS). The quality of life is more severely influenced when the Gross Motor Function Classification System (GMFCS) level increases.
More in-depth and impartial data collection on pediatric comorbidities is needed in the future. Professionals will be able to learn more about these people’s health-related quality of life as a result. In addition, greater research into the lives of children with cerebral palsy is needed to better understand and improve their quality of life.