Musculoskeletal Pathology in Cerebral Palsy: A Classification System and Reliability Study.
H Kerr GrahamPam ThomasonKate WilloughbyTandy Hastings-IsonRenee Van StralenBenan Dala-AliPeter WongErich RutzPublished in: Children (Basel, Switzerland) (2021)
This article presents a classification of lower limb musculoskeletal pathology (MSP) for ambulant children with cerebral palsy (CP) to identify key features from infancy to adulthood. The classification aims to improve communication, and to guide referral for interventions, which if timed appropriately, may optimise long-term musculoskeletal health and function. Consensus was achieved by discussion between staff in a Motion Analysis Laboratory (MAL). A four-stage classification system was developed: Stage 1: Hypertonia: Abnormal postures are dynamic. Stage 2: Contracture: Fixed shortening of one or more muscle-tendon units. Stage 3: Bone and joint deformity: Torsional deformities and/or joint instability (e.g., hip displacement or pes valgus), usually accompanied by contractures. Stage 4: Decompensation: Severe pathology where restoration of optimal joint and muscle-tendon function is not possible. Reliability of the classification was tested using the presentation of 16 clinical cases to a group of experienced observers, on two occasions, two weeks apart. Reliability was found to be very good to excellent, with mean Fleiss' kappa ranging from 0.72 to 0.84. Four-stages are proposed to classify lower limb MSP in children with CP. The classification was reliable in a group of clinicians who work together. We emphasise the features of decompensated MSP in the lower limb, which may not always benefit from reconstructive surgery and which can be avoided by timely intervention.
Keyphrases
- lower limb
- deep learning
- machine learning
- children with cerebral palsy
- cerebral palsy
- healthcare
- heart failure
- skeletal muscle
- randomized controlled trial
- minimally invasive
- public health
- plasmodium falciparum
- primary care
- immune response
- mental health
- depressive symptoms
- risk assessment
- body mass index
- coronary artery disease
- mass spectrometry
- nuclear factor
- early onset
- percutaneous coronary intervention
- toll like receptor
- human health
- liver failure
- health promotion