Children with cerebral palsy may be classified as Diplegic, Hemiplegic, Quadriplegic, Dyskinetic, Ataxic or a mixture of these depending on the presentation of their symptoms.
This classification system is useful for determining overarching areas of deficit, but can leave much to be desired when identifying a kiddos level of functional capacity or severity of disability.
While these traditional markers continue to be the primary method of classification used in the medical field, there is an additional system that can provide a more robust picture of the kiddo as a whole.
The Gross Motor Function Classification System (GMFCS) uses 5 levels to classify a child’s individual motor abilities through an analysis of functional mobility or more simply, how they get from place to place.
5 Levels of Cerebral Palsy
Level 1 includes children who have no restraints when walking. They can ambulate freely without instability. Typically children in this level do not wear any assistive devices.
Level 2 includes children who can walk without assistance but may have some difficulty at times. Typically these kiddos cannot jump or balance on one foot, may fall frequently and/or need to hold onto railings when walking up stairs or over curbs.
Level 3 includes children who need to use an assistive device to walk upright. These kiddos can walk in certain environments for reduced distances by self directing the use of devices such as revere walkers or forearm crutches. For longer distances children in level 3 will used wheeled mobility and can often self propel their chair.
Level 4 includes children who require external assistance in order to get around. They may use a wheelchair or a walker with significant help and support to compensate for lack of speed and/or stability. The child on the right is using a device called a Gait trainer, which provides trunk support for those who are unable to fully support themselves using a typical walker..
Level 5 includes children who require the assistance of a guardian for all movements. These kiddos often cannot support their head and trunk while seated and may utilize wheelchair positioning devices such as head rests and lateral supports.
Sometimes, the distinctions between different levels can be unclear. Kiddos can have varying abilities, depending on the day. The best way to determine which level is the best fit is to think of how the child gets around most of the time, not just their best performance.
GMFCS levels may seem to focus on lower body function, but many of these assistive devices require the use of arms and hands as well. Try using the RAPAEL Smart Kids if your child is having difficulties using their hands! RAPAELSmart Kids recommends customized games for the pediatric mind, providing consistent motivated training by displaying the results after each training exercise. Please visit our homepage (home.neofect.com) to find out more about RAPAEL Kids!
A Vietnam Veteran who had 3 strokes: Michael Eustace
I went to move and I couldn’t. I moved forward and slid right onto the floor. Started to get a little bit better and then I had another stroke. And then had problems with the heart and wound up having 3 strokes and 1 heart attack.
I couldn’t move my arm, I couldn’t move my hand, I couldn’t do anything. At that point I started to try to get better.
They kept saying, “What is your goal?”
I said my goal is to get up and walk again.
My goal is to get up and use my hand.
For me it was like it opened up a world of things that I could do with my hand, and get more mobility, because it motivates you to do more. You don’t appreciate things that you do before that you can’t do now.
"If it wasn’t for RAPAEL, I’d probably never bend my hand the way it is now."