Lecture 6

Question 1

GMFCS for CP before 2nd birthday

Answer 1

• Note: Walking is not yet the preferred method

I: Infants sit with both hands free to manipulate objects. Creep on hands and knees. Pull to stand and take steps while holding furniture. Some can walk between 18 months and 2 y.o. w/o the use of an AD.

II: Infants sit but utilize hands to maintain balance. Commando crawl.

III: Maintain sitting w/ low back supported.

IV: Have head control, but trunk support REQUIRED for floor sitting. Can roll

V: Infants unable to maintain antigravity head and trunk posture in prone and sitting. REQUIRE adult assistance to roll.

Question 2

GMFCS for CP between 2nd and 4th birthday

Answer 2

• Note: walking is now the preferred method

I: Children walk as the preferred method of mobility without AD. Able to floor sit w/ hands free to manipulate objects.

II: Children walk using an AD as preferred method of mobility. May have difficulty with balance when both hands are free. Movements in and out of sitting are performed without adult assistance. Creep on hands and knees.

III: Children walk with AD and adult assistance for steering and turning. W-sitting and may require adult assistance. Children creep on hands and knees often without reciprocal movement as their PREFERRED method of mobility.

IV: Self-mobility for short distances achieved WITHOUT reciprocal movement. Unable to maintain sitting balance without the use of hands.

V: All areas of motor function are limited. Children have NO MEANS of independent transport and are transported. Some children use power wheelchairs w/ extensive adaptations.

Question 3

GMFCS for CP between 4th and 6th birthday

Answer 3

• Note: Emerging ability to Run and Jump

I: Can get in and out of chair without hands. Can walk indoors & outdoors and stairs. Emerging ability to run and jump.

II: Can move from the floor to standing, but REQUIRE a stable surface to push or pull up from. Walk without AD. Able to climb stairs holding onto a railing, but UNABLE to run or jump.

III: Can sit on a regular chair, but REQUIRE pelvic or trunk support to maximize hand function. Use a stable surface to get in and out of sitting. Walk with an AD and climb stairs with assistance of an adult. Children frequently transported when traveling long distances.

IV: Move in and out of sitting with assistance from adult. Walks with AD and needs adult supervision w/ difficulty turning and maintaining balance on uneven surfaces.

V: All areas of motor function are limited. Children have no means of independent mobility and are transported.

Question 4

GMFCS for CP between 6th and 12th birthday

Answer 4

I: Children walk without most limitations, except speed, balance and coordination are reduced.

II: Children walk without most limitations, but experience limitations walking on uneven surfaces and confined spaces. Have, at best, minimal ability to perform gross motor skills such as running or jumping.

III: Walk with AD. Have to climb stairs holding a railing. Children proper a wheelchair manually or transported when traveling long distances or uneven terrain.

IV: Maintains levels of function achieved before age 6. May rely on wheeled mobility or power wheelchair.

V: Physical impairments restrict voluntary control of movement and child unable to maintain antigravity postures. All areas of motor function are limited. Child has no means of independent mobility and are transported.

Question 5

Manual Ability Classification Systems Levels

Answer 5

Level I: Handles objects easily and successfully
Level II: Handles most objects with somewhat reduced quality or speed of achievement
Level III: Handles objects with difficulty
Level IV: Handles a limited selection of easily managed objects in an adapted situation
Level V: Does NOT handle objects and has severely limited ability to perform simple actions

Question 6

Motor Milestones in Children with CP (refer to PowerPoint to obtain visuals)

Answer 6

1. Brings hands together and plays in SL
2. Holds head in midline, plays with hands in midline in sitting
3. Holds head up and looks around in prone on elbows
4. Lifts feet off floor in supine and rolls over
5. Plays in prone and belly crawls
6. Sits propped on both arms
7. Attains quadruped
8. Squat to Stad
9. Plays on knees while holding a stable object
10. Plays on knees - heel sit, propped on one hand and playing with the other
11. Heel sit and uses both hands to play
12. Creeps on hands and knees reciprocally
13. Sit on erect on bench
14. Pulls to stand at furniture, plays and cuises
15. Walks w/ reverse walker
16. Walks w/ forearm crutches
17. Stands without support
18. Walks independently

Question 7

Decipher the Clopton Gross Motor Alogrithm

Answer 7

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