Neuropediatrics 2011; 42 - P037
DOI: 10.1055/s-0031-1274009

Influence of hip luxation on health related quality of life (HRQL) in children with cerebral palsy evaluated by the CP-CHILD questionaire – preliminary results

NH Jung 1, O Brix 2, A Beyerlein 3, B Pereira 1, P Bernius 4, S Schroeder 2, T Koehler 5, S Weir 6, R von Kries 3, U Narayanan 6, S Berweck 7, V Mall 8
  • 1Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Abteilung für Neuropädiatrie und Muskelerkrankungen, Freiburg, Germany
  • 2Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Klinik für Neuropädiatrie und Sozialpädiatrie, München, Germany
  • 3Ludwig-Maximilians-Universität München, Institut für Soziale Pädiatrie und Jugendmedizin, München, Germany
  • 4Schön Klinik Harlaching, Klinik für Kinderorthopädie, München, Germany
  • 5Kinderzentrum Mecklenburg gGmbH, Schwerin, Germany
  • 6The Hospital for Sick Children, Division of Orthopedic Surgery, Toronto, Canada
  • 7Schön Klinik Vogtareuth, Klinik für Neuropädiatrie und neurologische Rehabilitation, Vogtareuth, Germany
  • 8Zentrum für Kinder- und Jugendmedizin, Abteilung für Neuropädiatrie und Muskelerkrankungen, Freiburg, Germany

Introduction: Lateralisation of the hip in children with cerebral palsy (CP) depends on motor impairment and varies from moderate impairment to severe pain. Less is known from children with CP and hip lateralisation and its influence on health related quality of life (HRQL). Thea im of the present study was to evaluate the influence of hip lateralisation on HRQL in children with CP via the Caregiver Priorities and Child Health Index of Life with Disabilities (CP-CHILD) questionaire.

Methods: We investigated 35 patients (mean age: 11.71±5.1; W: n=18) with bilateral cerebral palsy and Gross motor function classification system (GMFCS) Level III – V. Caregivers were asked to rate the quality of life via the CP-CHILD questionaire. Hip lateralisation was measured by the Migration index (MI) after Reimers. According to the „Hüftampel„ (www.cp-netz.de), patients were divided into a group with a high (MI>40%), medium (MI 25% bis ≤40%) and low (MI <25%) risk to develop progressive hip lateralisation. Two-way analysis of variance (ANOVA) with GMFCS and MI as factors was performed.

Results: 57,1% of patients with GMFCS Level III had a MI >40%, 13,3% with GMFCS Level IV and 30,8% with GMFCS Level V. Two-way ANOVA revealed a significant influence of GMFCS and MI on Total score of the CP-CHILD questionaire but not for the interaction of both (GMFCS: p=0,003 [F: 7,361; 2]; MI: p=0,008 [F: 5,807; 2]; MI*GMFCS: p=0,989).

Conclusion: We demonstrated – beside the GMFCS – a significant influence of hip lateralisation on HRQL. Our results support the need of an appropriate prevention and therapy of hip lateralisation in children with CP.