Aug. 2012, Volume 9, No. 4 (Serial No. 89), pp. 192–200 Journal of US-China Medical Science, ISSN 1548-6648, USA Relationship of Cerebral Palsy Subtypes and Activity Limitations Ozgun Kaya Kara 1 , Akmer Mutlu 1 , Mintaze Kerem Gunel 1 , Sevilay Karahan 2 , Ayşe Livanelioglu 1 and Meral Topcu 3 1. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, 06100 Samanpazari, Ankara, Turkey 2. Faculty of Medicine, Department of Biostatistics, Hacettepe University, 06100 Samanpazari, Ankara, Turkey 3. Faculty of Medicine, Department of PediatricNeurology, Hacettepe University, 06100 Samanpazari, Ankara, Turkey Abstract: Purpose: The aims of this study were to describe the relative proportions of cerebral palsy (CP) subtypes and associations between CP subtypes based on the Surveillance of Cerebral Palsy in Europe (SCPE) classification system; and to investigate the relationship between subtypes of CP and activity limitations as proposed in International Classification of Functional, Disability and Health (ICF). Method: The clinical types of the children were determined according to the definitions adopted for the SCPE. A total of 502 children with CP were identified. Activity limitations were studied with the Gross Motor Functional Classification System (GMFCS) for gross motor functionand the Manual Ability Classification System (MACS) for manual ability. The statistical analyses were performed with SPSS for Windows version 15.0. Results: GMFCS and MACS were associated with each other (r: 0.749, p < 0.001) regardless of the subtype. GMFCS and MACS were found to be associated in bilateral spastic, unilateral spastic, ataxic, dystonic and choreatetoid types (r: 0.86, r: 0.78, r: 0.70, r: 0.99, r: 0.82 respectively; p < 0.05). Conclusion: The study results stress the importance of merging information on CP subtypes, based on SCPE and functional motor evaluations. There is strong relationship between neurological subtype and activity limitations in children with CP. Key words: Cerebral Palsy, activity limitations, and classification 1. Introduction A common language on Cerebral Palsy (CP) has been developed for the European registers by the SCPE (Surveillance of Cerebral Palsy in Europe) working group [1]. The first important achievement of SCPE was to establish a consensus of standards, definitions and classification systems of CP [1, 2]. SCPE reached a consensus on the following definition that is a synopsis of the key elements of current CP definitions: CP is a group of permanent and non-progressive disorders of movement and posture and of motor function, caused by a non-progressive interference, lesion, or abnormality of the immature brain [3]. The classification of the Corresponding author: Ozgun Kaya Kara, PT, MSc, research field: pediatric rehabilitation. E-mail: ozgun_kaya@yahoo.com. heterogeneous group of children with CP has recently become more important [4]. Classifications have been made based on the anatomical site of the brain impairment; the clinical symptoms and signs, e.g., spastic conditions, dyskinesias or ataxias; the topographical involvement of the extremities, e.g., hemiplegia, diplegia, quadriplegia; the degree of muscle tone, e.g., isotonic, hypotonic or hypertonic; and the timing of the presumed insult, e.g., prenatal, perinatal or postnatal [5]. To these problems of definition and classification are added the variation over time of symptoms and signs in a child and the variation between the assessing clinicians and those interpreting these symptoms and signs [4]. A decision tree to enable a case to be allocated to a given type of CP has been formulated by SCPE [3]. In DAVID PUBLISHING D