Quality of life of children with cerebral palsy: an analytical cross-sectional study

Background. Pediatric quality of life (QoL) reflects a child’s physical, emotional, social, and cognitive well-being within the cultural and family context. Cerebral palsy (CP), the most common childhood motor disability, significantly reduces QoL. This study aims to describe the QoL of children with CP and healthy children, and to examine whether QoL varies according to the functional abilities of children with CP. Methods. This analytical cross-sectional study was conducted at the Teaching Hospital, Jaffna, Sri Lanka using an investigator-administered questionnaire. Children with CP comprised the case group, and controls were matched in a 1:1 ratio based on age, sex, socioeconomic status, and geographical area. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS) were used to assess functional ability. Quality of life was assessed using the PedsQL™ 3.0 CP Module. Results. A total of 66 children with CP and 66 age-matched controls were recruited. Both groups had a median age of 7 years (interquiartile range [IQR]: 6-10 years), with the majority (53%) aged 5-7 years. Quadriplegia was the most common type (34.8%) of cerebral palsy. The median total quality of life score was significantly lower among cases than among controls (59.27 [IQR: 33.80-77.41] vs 100 [IQR: 100- 100]; p < 0.0001). Significant differences were observed across all domains between the two groups (p < 0.0001). According to the functional classification systems (GMFCS, MACS, CFCS, and EDACS), children with greater dependence in mobility, more limited manual abilities, greater communication restrictions, and greater feeding assistance needs had significantly lower overall QoL scores compared with their more independent counterparts (p < 0.0001). Conclusion. The quality of life of children with CP was significantly lower than that of healthy children. Quality of life scores significantly differed across levels of functional ability, with children with greater functional limitations showing poorer outcome.