Abstract
Children with cerebral palsy (CP) demonstrate significant problems with executive functioning that affect daily occupations. This study is the first to connect cognitive control abilities and behavioral self-regulation with functional walking in pediatric CP.
Primary Author and Speaker: Megan Sofield
Additional Authors and Speakers: Katherine Dimitropoulou
Contributing Authors: Nancy Davila Belendez, Emily Avisado, Cynthia Hsu, Brian Wishart, Mara Yale, Jacqueline Chen
Cerebral palsy (CP) is the most common motor disability in childhood, impacting balance control, and muscle tone with consequences on functional mobility. Traditionally, CP has been considered a motor disability. However, the impact on occupational engagement across development is beyond motor abilities. Studies reveal that children with CP demonstrate significantly lower executive functioning (EF) abilities than their typically developing peers. In this study, we examine the relationship between EF and functional mobility in ambulatory children with CP. We examine EF using the Behavior Rating Inventory of Executive Functioning (BRIEF-2) assessment. The BRIEF-2 is a parent report. It has 3 major areas of EF: Behavioral regulation, Cognitive control and Emotional Regulation, as well as an overall Composite score. We examine functional mobility using the 6-minute walk test, during which participants walk for six minutes on a 30-meter walkway. A total of 13 children/adolescents with CP, GMFCS I-III participated in the study. Results reveal significant relationships between performance on the 6-minute walk test (functional mobility) and the behavioral regulation (BRI) and cognitive control (CRI) of action. We conducted Pearson’s r correlations between the total distance covered and the average number of steps per walking lap (lap: 30 meters walk back and forth) with each of the variables in the BRIEF-2. There are significant correlations between the two functional walking variables (distance and average number of steps/lap) and the BRI overall, with significant findings for self-monitoring (all p <.05). There are significant correlations between the two functional walking variables and the overall CRI (p<0.5), with specific findings for initiation, planning and organization, and task monitoring (all ps<.05). This study is the first to connect cognitive control abilities and behavioral self-regulation with functional walking ability in children and adolescents with CP.
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