Comparison of functional walking, balance and functional independence in children with diplegic and hemiplegic cerebral palsy

Cerebral palsy (CP) defines as a group of permanent movement and posture development disorders that cause limitation of activity attributed to non-progressive disorders which have occurred in the developing brain of the infant or child and it is the most common physical disability in childhood. Damage to the brain does not progress and occurs in areas of the brain that control muscle tone, gross and fine motor functions, balance control, reflexes and posture. Accordingly, patients' walking abilities, balance and success in functional activities are greatly affected. As a result, the objective of this study was to compare children with hemiplegia to children with diplegia at GMFCS levels I, II, and III, using multiple validated outcome tools to assess functional walking, balance, and functional independence. A quasi-experimental design study including 60 children with cerebral palsy was conducted at three hospitals in Wasit province, Iraq. Thirty patients with diplegia and 30 patients with hemiplegia aged 0 to 18 years and classified as GMFCS level I-III had their demographic information recorded. Patients were evaluated with Gillette Functional Gait Assessment Questionnaire (FAQ), the Pediatric Balance Scale (PBS) and the Independence Measure for Children (WeeFIM).The statistical analysis showed a significant difference between the groups in FAQ and PBS (p<0.05), although no significant difference in WeeFIM. The self-care and social cognition subgroups of WeeFIM showed a significant difference between the groups (p<0.05).These findings show that children with hemiplegia had considerably better walking, balance and lower extremity function but worse upper extremity function than children with diplegia. Specialists should examine measures to improve the functionality of CP patients' compromised limbs in order to improve their daily performance.