Investigation of the relationship between functionality, disability status, muscle strength and spasticity in individuals with cerebral palsy

This study aims to evaluate the functionality, disability, and health status of individual with cerebral palsy, and to examine the relationships between muscle strength and muscle tone. The study aimed to understand the relationship between muscle strength and muscle tone in individual with cerebral palsy, and also focused on the interactions between motor skills (both gross and fine motor) and communication abilities. In the study, muscle tone was assessed using the Modified Ashworth Scale (MAS), while muscle strength was evaluated using the Manual Muscle Testing (MMT). Functional abilities were analyzed using the GMFCS (Gross Motor Function Classification System), MACS (Manual Ability Classification System), and CFCS (Communication Function Classification System) scales. The research findings indicate that with increasing age, the body mass index (BMI) of children with cerebral palsy also increases. This increase has been associated with immobility and weight gain, which may affect the health of these individuals. Additionally, a positive correlation was found between GMFCS and CFCS scores, suggesting that motor functions are related to communication skills. Similarly, a positive correlation was observed between MACS and CFCS scores, indicating a relationship between manual abilities and communication skills. A positive correlation was also observed between GMFCS and MACS, indicating that gross motor skills and fine motor skills influence each other. The study revealed a strong relationship between participants' communication skills and the PODCI "Upper Extremity Functionality", "Transfer and Basic Mobility", "Sports and Physical Activity", and "General Functionality" levels. It was particularly observed that participants with better communication skills had better mobility, sports activities, and general functionality levels. This study provides an original contribution to the literature by examining the relationships between PODCI, CFCS, and MACS. The study also found that the levels of gross and fine motor functionality were related to the "Upper Extremity Functionality" and "General Functionality" scores of the PODCI participation scale. These findings suggest that improvements in gross motor skills are related to hand skills and that communication functionality and physical abilities are interconnected. A strong negative relationship was found between individuals' PODCI general functionality scores and their levels of gross motor function, hand function, and communication function. Another significant finding is the negative relationship between spasticity and muscle strength. However, this finding does not align with existing literature. In the literature, it has been suggested that the relationship between spasticity and muscle strength involves more complex dynamics and requires further in-depth investigation. Keywords: Cerebral palsy, spasticity, muscle tone, muscle strength, motor function, communication function, functionality