Investigating the relation between environmental factors and activity-participation in children with cerebral palsy

The aim of this study was to investigate the relationship between environmental factors and activity and participation in children with cerebral palsy (CP). In the scope of the study, firstly Turkish validity and reliability of European Child Environment Questionnaire (ECEQ) was investigated to evaluate environmental factors. For validity and reliability of the ECEQ questionnaire, ECEQ and Pediatric Evaluation of Disability Inventory (PEDI) were completed by 306 families of children with CP aged between 2 and 18 years. Test-retest evaluation was completed with 65 parents. Secondly 106 children with CP aged between 5 and 13 years and their parents were selected from the same sample to determine the relationship between environmental factors and activity and participation. Functional status was determined by gross motor function level (Gross Motor Function Classification System-Expanded&Revised-GMFCS-ER), fine motor function level (Manual Ability Classification System-MACS), communication function level (Communication Function Classification System-CFCS) and eating drinking function level (Eating Drinking Ability Classification System-EDACS). Activity (Gross Motor Function Measurement-GMFM-88), participation (Life Habits Questionnaire-LIFE-H), familial impact (Impact on Family Scale-IPFAM), personal factors (demographic information) and environmental factors (ECEQ) were evaluated. As a result; Turkish ECEQ questionnaire was valid (RMSEA <0.080; p <0.05) and reliable (Cronbach alpha >0.90; ICC >0.70). The most important factor affecting activity and participation of children with CP was determined as functional status. Personal factors including gestational weight and gestational age, comorbid problems like epilepsy, bladder-bowel, speech and swallowing problems, familial impact and environmental factors were associated with activity and participation limitations (RMSEA <0.080; p <0.05). According to these findings, we can say that the detailed evaluation of personal factors, familial factors, environmental factors that may affect activity and participation in children with CP is important in structuring a rehabilitation program to increase activity and participation in clinical practice.