Gross Motor Dysfunction in Children with Cerebral Palsy in Bauchi, North-East Nigeria

INTRODUCTION: Cerebral palsy (CP) is a common childhood neurological disorder with the hallmark of varying degrees of impaired motor function. Identifying the factors that influence children’s motor outcomes with CP will lead to a more informed treatment and prognostication approach.
METHODS: This was a cross-sectional cohort study involving 70 consecutively enrolled children with CP. Information on socio-demographic background and risks for developing CP was obtained. The children were assessed for common CP-related comorbidities, gross motor function was evaluated with the aid of GMFCS-E&R, and the clinical subtypes of CP were recorded. The data were analyzed using IBM SPSS Statistics V21.
RESULTS: The subjects’ mean age was 49 months, and most (40%) were from the lower socio-economic cadre. The majority (44.3%) were at GMFCS level V and 62.9% were non-ambulatory. The odds of having non-ambulatory CP were higher among children with quadriplegic CP (p=0.000, CI=0.010-0.228, OR=0.048) and those who had jaundice as a risk factor (p value=0.038, CI=0.118-0.961, OR=0.336). Whereas, the presence of a single risk factor, as opposed to multiple risk factors, was associated with higher odds of being ambulatory (p=0.028, CI=1.113-10.702, OR=3.451).
CONCLUSION: The exposure to multiple adverse factors at birth and early neonatal life may explain why most of the children with CP in this study were non-ambulatory. This calls for improvement in the spread and quality of intrapartum and early neonatal care. Furthermore, we have demonstrated the link between topographical subtype and ambulatory potentials, which may have far-reaching counseling and prognostic value.