Influence of gait analysis on decision-marketing for lower extremity surgery

The relationship between quality of life and functioning for children with cerebral palsy: does poor functioning equate with poor quality of life?

A SHELLY BSC (HONS) A, E DAVIS PHD A, E WATERS DPHIL A,
A MACKINNON PHD B, D REDDIHOUGH MD BSC FRACP FAFRM C, D, G,
R BOYD MSC (PT) PHD C, S REID MCLINEPI C, H K GRAHAM MD,
FRCS (ED) FRACS C,E,F,G

  1. 1. School of Health and Social Development, Deakin University;
  2. 2. Centre for Mental Health Research, Australian National University;
  3. 3. Murdoch Children’s Research Institute;
  4. 4. Department of Child Developmental and Rehabilitation;
  5. 5. Department of Orthopaedics, Royal Children’s Hospital;
  6. 6. Clinical Centre for Research Excellence (CCRE) in Gait Rehabilitation;
  7. 7. Department of Paediatrics, University of Melbourne, Australia

Objective: Quality of Life (QoL) is increasingly being used to complement traditional outcome variables in evaluating the effectiveness of interventions for children with cerebral palsy (CP).  QoL is defined in a variety of ways and many definitions equate to QoL to functioning. A few studies  of children with cerebral palsy have demonstrated that functioning and QoL are correlated, however these studies have used QoL questionnaires that measure a child’s difficulties and focus on what a child can do. The aim of this study was to examine the relationship between functioning and QoL domains using a new condition-specific QoL questionnaire that focuses on wellbeing (CP QoL-Child) in a sample of children with CP.

Study Design: A cross-sectional survey.

Study Participants/Setting: From an eligible total of 695 families, 205 primary caregivers of children aged 4 to 12 years with CP and 53 children aged 9  to 12 years with CP participated within their homes. The children, evenly distributed across sex (56% male) were sampled across Gross Motor Function Classification System (GMFCS) levels (Level I=18%, II=28%, III=14%, IV=11%, V=27%).

Method: Participants received a questionnaire by mail. Both parents and children (if aged 9-12y) completed the CP QoL-Child, a Qol questionnaire that has demonstrated reliability and validity. The CP QoL-Child © assesses social wellbeing and acceptance, feelings about functioning, participation and physical health, emotional wellbeing, access to services, pain and feeling about disability, and family health. Parents also completed the parent reported GMFCS.

Results: For parent proxy-report, feelings about functioning and participation and physical health accounted for more of the variance in functioning than social wellbeing and acceptance and emotional wellbeing. Similar results were obtained for child self-report, where only feelings about functioning, participation and physical health, and pain and feelings about functioning predicted functional level.

Conclusions: This is the first study to examine empirically the relationship between functioning and QoL domains using a QoL instrument that focuses on  wellbeing  rather than functioning. The results demonstrate that although QoL domains predict functioning level, the strength of the relationship depends on the QoL domain. It is incorrect to assume that if a child is less able to `do’ something they have poorer QoL on all domains. These results have implications for defining, measuring, and interpreting children’s QoL.

Acknowledgements: National Health and Medical Research Council, Telstra Foundation, and the Victorian Cerebral Palsy Register, which is supported by the Victorian Medical Insurance Agency Ltd.

 
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