Relationship between functional lower limb capacity and falls in ambulant children with cerebral palsy.

AIM: Ambulant children with cerebral palsy (CP) are at a high risk of falls. It is important to identify characteristics associated with increased falls and understand which clinical measures are associated with falls in this population.

METHOD: This study explored parent-reported falls of 66 children with CP (Gross Motor Function Classification System [GMFCS] I - III) and the associations between lower limb functional measures (6-Minute Walk Test, Muscle Power Sprint Test, 10 Metre Walk Test, Sit-to-Stand, Lateral Step-up, Kneel-to-Stand) and the number of falls. Receiver operating characteristic (ROC) curve analysis identified score thresholds for the likelihood of falling more than average.

RESULTS

81% of children fell at least once in the previous month, with an average of 11 falls and 44% children who fell were injured. Children in GMFCS level II had the greatest number of falls. Poorer performance on Sit-to-Stand, Lateral-Step-Up and Kneel-To-Stand were associated with fall frequency. ROC thresholds for likelihood of above average fall frequency were identified for lateral step-up best side (score ≤17), sit-to-stand (score ≤15) and kneel-to-stand best side (score ≤ 4).

INTERPRETATION: Ambulant children with CP are at high risk of falls. Poor performance in several lower limb assessments incorporating balance ware associated with higher fall frequency.