The Investigation of Relationship and Predictive Role of Environmental Factors on Participation of Children With Diplegic Spastic Cerebral Palsy Spectrum Disorder: A Primitive Study

Introduction: Cerebral palsy spectrum disorder is the most common motor disability in childhood and it is a neurodevelopmental condition beginning early in life and persisting throughout the lifespan. In addition to motor problems that affect the childchr('39')s participation, the environment factors might also reduce or increase the level of participation. The aim of this study was to The investigation of relationship and predictive role of environmental factors on participation of children with cerebral palsy spectrum disorder. Methods and analysis: In this cross-sectional research, the study population was children with cerebral palsy and their parents. 116 children with diplegic spastic and their parents were recruited by convenience sampling method in 2018-2019 in occupational therapy clinics in Tehran, Mazandaran and Alborz provinces. Parents complete the European Children Environmental Questionnaire and the Life Habits Questionnaire, which were designed to assess the child environmental factors and participation, respectively. The Gross Motor Function Classification System expanded and Revised and Sparkle cognitive level scale were used to classification of gross motor function especially walking and estimate intelligence quotient respectively. Pearson correlation coefficient and linear regression of SPSS software version 22 were used to analyze the results. Findings: 23.3% of these children were in level I, 27.6% in level II, 31.9% in level III and 17.2% in level IV of the GMFCSE&R. 89.7% had an IQ above seventy-five and 85.3% had no seizures. All parts and subscales of environmental factors had significantly correlated with participation (P <0.01). The physical environment had the highest correlation with participation (r = -0.811, P <0.01). In the linear regression model, the physical environment (b = -0.475, P <0.01) and attitude (b = -0.285, p <0.05) were involved in predicting participation (r2 = 0.71). Conclusion: Physical environment in addition to good correlation with social participation in children with diplegic spastic cerebral palsy spectrum disorder, along with attitude are predicting factors the level of participation. Therefore, modification and adaptations at home, community, school and especially transportation can increase the participation of children with spastic diplegic.