The impact of the environment on functional status, participation and quality of life in children with Cerebral Palsy

The aim of this study is to investigate the impact of environmental factors on the functional status, participation, and quality of life in children with cerebral palsy (CP). A study was conducted involving 68 children (41F 27M) with an average age of 10.91±2.99 years. Following the collection of individuals' socio-demographic data, assessments were made using the European Children's Environment Questionnaire (ECEQ), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Eating and Drinking Ability Classification System (EDACS), Communication Function Classification System (CFCS), Pediatric Disability Evaluation Scale (PEDI), Child and Adolescent Scale of Participation (CASP), and Pediatric Quality of Life Scale (PedsQL). The ECEQ environmental survey showed a strong to very strong correlation with GMFCS for assessing functional status (r=0.731-0.853), a strong correlation with MACS (r=0.693-0.751), a moderate correlation with EDACS (r=0.536-0.591), and a moderate to strong correlation with CFCS (r=0.540-0.619) (p=<0.001).Furthermore, concerning the evaluation of participation using the ECEQ survey, significant negative correlations were found between PEDI self-care (r=-0.761-0.870), PEDI mobility (r=-0.674-0.858), PEDI social function (r=-0.691- 0.783), PEDI total (r=-0.755-0.886), CASP home participation (r=-0.723-0.857), CASP neighborhood and community participation (r=-0.699-0.854), CASP school participation (r=-0.701-0.820), CASP home and community activities (r=-0.609- 0.849), CASP total (r=-0.715-0.879) scales (p=<0.001).Additionally, when assessing quality of life using the ECEQ survey, there were moderate to strong negative correlations observed with PedsQL physical function (r=-0.700-0.887), PedsQL emotional function (r=-0.434-0.558), PedsQL social function (r=-0.725- 0.818), PedsQL school functions (r=-0656-0.743), and PedsQL total (r=-0.714- 0.853) (p=<0.001). These outcomes underscore the importance of a detailed assessment of environmental factors and attitudes in children with cerebral palsy, as it will be crucial in determining individualized rehabilitation programs. KEYWORDS: Cerebral palsy, Environment, Functional status, Quality of Life, Participation