Cerebral palsy (CP) is one of the common causes of disability in childhood. The
prevalence of the disease has been evaluated as 2-3 per 1000 live births on average in
various societies. In various prevalence studies conducted in our country, the prevalence
of the disease was found to be 1.1- 4.4 per 1000 live births.
CP is a disease with multifactorial etiology. Although antenatal, perinatal and neonatal
effects often play a role together, the most important known risk factors are low birth
weight and prematurity. Intrauterine infections have been identified as the most
important cause of CP etiology in individuals with prematurity and low birth weight.
These infections can trigger premature birth and cause damage to the central nervous
system, which has not yet completed its development.
In CP, classifications are made according to the extremity involvement, clinical
features, etiologies and many different pathogenesis. Currently, the most common and
widely used classification is the one defined by Phelps and Perlstein according to the
involved extremity and tonus disorder.
A) Spastic type: (pyramidal): Monoplegia, Diplegia, Hemiplegia, Triplegia, Tetraplegia B)
Dyskinetic type: (Extrapyramidal): Athetoid, Choreic, Choreoathetoid, Dystonic C) Ataxic
type D) Hypotonic type E) Mixed type Materials and Methods The study was designed to
determine the optimal cut off value of the modified ashworth scale in the evaluation of
gait performance and functional mobility in individuals with CP aged 6-15 years. Patients
admitted to the CP outpatient clinic of Kayseri City Hospital, Physical Medicine and
Rehabilitation Clinic and Twenty-five individuals who meet the inclusion criteria will be
included in the study.
Modified Ashworth Scale 0 : Normal muscle tone. 1 : Slight increase in muscle tone,
minimal resistance is felt at the end of joint movement.
1+ : Minimal resistance in less than half of the joint movement. 2 : Significant
increased muscle tone throughout the entire movement, but the joint can still be moved
easily.
3 : There is significant increased muscle tone throughout the entire movement making
passive movement difficult.
4 : The affected muscles are completely rigid, remaining in fixed flexion or extension.
Gross Motor Function Measure Classification System (GMFCS) KMFSS, which is one of the
most widely used scales to classify the severity of movement disorders in individuals
with CP and to evaluate the current activity levels of the subjects, was developed by
Palisano et al. in 1997. In 2012, El et al. conducted a validity and reliability study of
the CMFCS for the Turkish population.
Gross motor function classification system Level 1 Walks independently. There is
limitation in advanced gross motor skills.
Level 2 Walks without an assistive device. Has limitations when walking in public.
Level 3 Walks with an assistive device. There is limitation while walking in the
community.
Level 4 Has limitations. Self-mobile. Transported in the community or uses a wheelchair.
Level 5 Mobilization is severely limited even with assistive technologies. 10 meter walk
test: It is used to measure walking speed from functional parameters. A 16-meter walking
track is created to perform the test. The first 3 and last 3 meters of this track are
completed without taking into account and the measurements are repeated 3 times each.
Before the test is performed, starting and ending points are determined on non-slippery
ground. The individual starts walking, the stopwatch is started after the first three
meters. The stopwatch is stopped at the end of the tenth meter. After the individual
walks the last 3 meters, walking is terminated. The completion time of the test is
recorded in seconds.
Assessment of Mobility TUG test: It was performed using a standard chair (46 cm high).
Patients sat with their backs against the chair. Patients were instructed to get up from
the chair without support, walk three meters marked on the floor, turn around, walk back
to the chair and sit down again. Patients were told that the test should be performed at
a normal pace. The stopwatch was started with the word "start" and stopped when the
patient sat down. TUG time was measured in seconds (s).
Five Times Sit and Stand Test: It is used for functional mobility measurements. In the
test, the individual sits with arms crossed over the shoulders and back leaning against
the chair. With the "go" command, the patient stands up and sits down five times quickly
from the standard chair. The elapsed time is measured with a stopwatch.
