Factors Affecting the Independence Level of 4-6-Year-Old Children with Cerebral Palsy in Activities of Daily Living

ObjectivesEnhancing the independence of children with cerebral palsy in their daily activities can significantly alleviate caregiver stress and challenges, thereby improving the quality of life for caregivers.. This study aimed to identify the influential factors in the independence level of children with CP in Activities of Daily Living (ADL) (selfcare) and Instrumental Activities of Daily Living (IADL) (home participation).Materials & MethodsIn this cross-sectional study, 116 children with different types of CP (61 boys and 55 girls) in the 4-6 age range and their parents were non-randomly selected through convenience sampling. The Iranian-Children Participation Questionnaire was used to measure the children's independence level in self-care activities and home participation. Several instruments, along with a demographicquestionnaire, were used to assess personal factors, such as the Gross Motor Function Classification System, Manual Ability Classification System, Communication Function Classification System, SPARCLE (for determining children's cognitive level), and Eating and Drinking Ability Classification System. Eventually, the collected data were analyzed using stepwise linear regression ResultsThe results showed that the level of Gross Motor Function Classification System (GMFCS) and Communication Function Classification System (CFCS) and the child's age had the most correlation with the independence level in self-care activities. Moreover, GMFCS Manual Ability Classification System (MACS), cognitive level, and child's age were most associated with home participation.ConclusionPersonal factors are more effective than environmental factors in determining the independence of children with CP

The Association of Balance, Fear of Falling, and Daily Activities With Drug Phases and Severity of Disease in Patients With Parkinson

Introduction: In the elderly, functional balance, fear of falling, and independence in daily living activities are interrelated; however, this relationship may change under the influence of drug phase and the severity of disease in individuals with idiopathic Parkinson disease. This study aimed to investigate the association of functional balance, fear of falling, and independence in the Activities of Daily Living (ADL) with the drug on- and drug off-phases. Methods: A total of 140 patients with Parkinson disease (age: Mean±SD; 60.51±12.32 y) were evaluated in terms of their functional balance, fear of falling, and independence in their daily activities by the Berg Balance Scale (BBS), Fall Efficacy Scale-International (FES-I), and Unified Parkinson Disease Rating Scale-ADL (UPDRS-ADL), respectively, in drug on- and drug off-phases. The Hoehn and Yahr scale recorded global disease rating. The Spearman coefficient, Kruskal-Wallis, and Mann-Whitney tests were used to find out whether the distribution of scale scores differs with regard to functional balance or disease severity. Results: A strong correlation was found between the functional balance, fear of falling, and independence in ADL with both drug phases. The results also showed the significant difference in the distribution of the FES-I and UPDRS-ADL scores with regard to functional balance (except independence in ADL in drug off-phase). Also, the distribution of the scores of BBS, FES-I, and UPDRS-ADL showed significant differences with regard to disease severity. Conclusion: The study showed a strong correlation between functional balance, fear of falling, and independence in ADL that can be affected by the drug phase and severity of the disease. However, more studies are needed to understand this relationship precisely.This work was supported by the Student Research Committee in Iran University of Medical Sciences, Tehran, Iran.S