Upper Extremity Function, School Performance, and Academic Success in Children With Cerebral Palsy (CP-SCHOOL)
Investigation of the Relationship Between Upper Extremity Functionality, Academic Achievement, School Performance, and Perception of Success in School-Aged Children With Cerebral Palsy
The aim of this study is to investigate the relationship between upper extremity functionality and school-related outcomes, including academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy. The study specifically aims to evaluate how upper extremity motor function is associated with academic participation and school-based functional performance.
The main hypotheses are:
H0: There is no significant relationship between upper extremity functionality and academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy.
H1: There is a significant relationship between upper extremity functionality and academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy.
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
Cerebral palsy (CP) is a group of permanent movement and posture disorders caused by non-progressive disturbances in the developing brain. It is one of the most common neurodevelopmental conditions in childhood and is frequently associated with upper extremity impairments that may affect functional independence, fine motor skills, and participation in daily and school-related activities.
Upper extremity function plays a critical role in school participation, particularly in tasks such as writing, object manipulation, classroom material use, and task completion. Children with cerebral palsy often experience limitations in manual ability, which may directly or indirectly influence academic performance, school participation, and their perception of success in the school environment.
Despite the known impact of motor impairments on functional outcomes, the relationship between upper extremity functionality and school-related outcomes such as academic achievement, school performance, and perceived academic success has not been sufficiently clarified in school-aged children with cerebral palsy. Existing literature generally focuses on either motor function or academic outcomes separately, and studies evaluating these domains together remain limited.
In this context, a cross-sectional observational study will be conducted in school-aged children diagnosed with cerebral palsy who are actively attending school. Participants who meet the inclusion criteria and whose legal guardians provide informed consent will be included in the study.
Sociodemographic and clinical data will be collected using a structured data form. Upper extremity functionality will be evaluated using the Manual Ability Classification System (MACS) and ABILHAND-Kids. Academic achievement will be assessed using school report card grades. School performance will be evaluated using a standardized academic performance assessment scale. Perceived academic success will be measured using a validated school success perception scale.
All assessments will be performed in a single session under standardized conditions by trained physiotherapists. No intervention will be applied, and participants will continue their usual education and rehabilitation routines without any modification.
The collected data will be analyzed to determine the relationship between upper extremity functionality and school-related outcomes in children with cerebral palsy.
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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İ̇stanbul
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Istanbul, İ̇stanbul, Turkije (Türkiye), 34755
- Yeditepe University Faculty of Health Sciences
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
- Diagnosis of cerebral palsy
- Age between 6 and 18 years
- Attending school (primary or secondary education)
- Ability to understand and follow simple instructions
- Consent from parents/guardians and assent from children when applicable
Exclusion Criteria:
- Severe cognitive impairment preventing assessment participation
- Severe visual or hearing impairments affecting test performance
- Recent orthopedic surgery or botulinum toxin injection within the last 6 months
- Other neurological or musculoskeletal conditions affecting upper extremity function
- Inability to complete evaluation procedures
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
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Cerebral Palsy Upper Extremity Function Group (CP-UEF-G)
The study population consists of school-aged children diagnosed with cerebral palsy who meet the inclusion criteria and are actively attending school. The study is designed as a cross-sectional observational study and aims to evaluate the relationship between upper extremity functionality and school-related outcomes. Participants will not receive any experimental intervention. All participants will continue their routine medical care, rehabilitation programs, and school activities without any modification. All assessments will be conducted in a single session and will include evaluation of upper extremity functionality, academic achievement, school performance, and perceived academic success. Upper extremity functionality will be assessed using the Manual Ability Classification System (MACS) and ABILHAND-Kids. Academic achievement will be evaluated using school report card grades. School performance will be assessed using a standardized academic performance evaluation scale. Percei |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Upper Extremity Functionality (MACS)
Tijdsspanne: [Time Frame: Baseline assessment (single session)]
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The Manual Ability Classification System (MACS) was used to evaluate upper extremity functional ability in children with cerebral palsy.
MACS classifies how children use their hands to handle objects in daily activities.
The system consists of five levels, ranging from Level I (handles objects easily and successfully) to Level V (does not handle objects and has severely limited ability).
Scores range from 1 (minimum) to 5 (maximum).
Lower levels indicate better manual ability and functional independence.The scale ranges from 1 (minimum) to 5 (maximum).
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[Time Frame: Baseline assessment (single session)]
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Upper Extremity Functional Performance (ABILHAND-Kids)
Tijdsspanne: [Time Frame: Baseline assessment (single session)]
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The ABILHAND-Kids questionnaire was used to assess perceived manual ability in children with cerebral palsy.
It evaluates the child's ability to perform daily activities involving upper extremity use, such as dressing, writing, and handling objects.
The scale consists of 21 items, with total scores typically converted to a logits scale (or summed scores ranging from 0 to 42), where 0 represents the minimum and 42 represents the maximum ability.
Higher scores indicate better manual ability and functional performance in daily life.The total score ranges from 0 (minimum) to 42 (maximum).
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[Time Frame: Baseline assessment (single session)]
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Academic Achievement
Tijdsspanne: [Time Frame: Most recent academic term at baseline]
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Academic achievement was evaluated using students' official school report card grades.
This measure reflects overall academic success in core subjects and provides an objective indicator of educational performance.
Grades are reported on a scale from 0 (minimum) to 100 (maximum).
Higher grades indicate better academic achievement.
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[Time Frame: Most recent academic term at baseline]
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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School Performance
Tijdsspanne: [Time Frame: Baseline assessment (single session)]
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School performance was assessed using the Academic Performance Evaluation Scale.
This measure evaluates the child's participation, task completion, attention, and functional performance in the school environment.
The scale consists of 19 items.
Mean scores range from 1 (minimum) to 5 (maximum).
Higher scores indicate better school functioning and academic participation.The total score ranges from 0 (minimum) to 42 (maximum).
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[Time Frame: Baseline assessment (single session)]
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Perceived Academic Success
Tijdsspanne: [Time Frame: Baseline assessment (single session)]
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Perceived academic success was measured using the Perception of Success Scale.
TIn this 24-item scale, for positive statements that support success, a score of 5 is given for "Strongly Agree" and 1 for "Strongly Disagree".
For negative statements that hinder success, the scoring is reversed from 1 to 5 and then summed.
A high total score indicates that the student has a strong and positive perception of success, high academic self-confidence, and effectively utilizes factors that support success.
Conversely, a low total score indicates that the student feels significant obstacles to success (such as anxiety, lack of planning, lack of motivation, etc.) and may need support in academic processes.
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[Time Frame: Baseline assessment (single session)]
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Sociodemographic and Clinical Data
Tijdsspanne: [Time Frame: Baseline assessment (single session)]
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Sociodemographic and clinical characteristics, including age, gender, diagnosis details, and functional level, were collected using a Structured Clinical Data Form to describe the study population.
Age is measured in years, while categorical data such as gender and functional level are reported as frequencies and percentages.
Each variable is aggregated as a single descriptive value (mean or frequency) to provide a baseline profile of the participants.
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[Time Frame: Baseline assessment (single session)]
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Medewerkers en onderzoekers
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Publicaties en nuttige links
Algemene publicaties
- Akpinar P, Tezel CG, Eliasson AC, Icagasioglu A. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabil. 2010;32(23):1910-6. doi: 10.3109/09638281003763796.
- Constand MK, MacDermid JC. Applications of the International Classification of Functioning, Disability and Health in goal-setting practices in healthcare. Disabil Rehabil. 2014;36(15):1305-14. doi: 10.3109/09638288.2013.845256. Epub 2013 Oct 23.
- Makki D, Duodu J, Nixon M. Prevalence and pattern of upper limb involvement in cerebral palsy. J Child Orthop. 2014 May;8(3):215-9. doi: 10.1007/s11832-014-0593-0. Epub 2014 May 14.
- Park H, Choi JY, Yi SH, Park ES, Shim D, Choi TY, Rha DW. Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study. BMC Pediatr. 2021 Oct 19;21(1):459. doi: 10.1186/s12887-021-02927-2.
- Kim HY. An investigation of the factors affecting handwriting articulation of school aged children with cerebral palsy based on the international classification of functioning, disability and health. J Phys Ther Sci. 2016 Jan;28(2):347-50. doi: 10.1589/jpts.28.347. Epub 2016 Feb 29.
- Tukel Kavak S, Eliasson AC. Development of handwriting skill in children with unilateral cerebral palsy (CP). Disabil Rehabil. 2011;33(21-22):2084-91. doi: 10.3109/09638288.2011.560335. Epub 2011 Mar 30.
- Sahin E, Dilek B, Karakas A, Engin O, Gulbahar S, Faruk Dadas O, Peker MO, El O. Reliability and Validity of the Turkish Version of the ABILHAND-Kids Survey in Children with Cerebral Palsy. Turk J Phys Med Rehabil. 2020 Jun 24;66(4):444-451. doi: 10.5606/tftrd.2020.4091. eCollection 2020 Dec.
- Micheletti S, Galli J, Vezzoli M, Scaglioni V, Agostini S, Calza S, Merabet LB, Fazzi E. Academic skills in children with cerebral palsy and specific learning disorders. Dev Med Child Neurol. 2024 Jun;66(6):778-792. doi: 10.1111/dmcn.15808. Epub 2023 Nov 21.
- Marsh HW, Martin AJ. Academic self-concept and academic achievement: relations and causal ordering. Br J Educ Psychol. 2011 Mar;81(Pt 1):59-77. doi: 10.1348/000709910X503501.
- Jovellar-Isiegas P, Resa Collados I, Jaen-Carrillo D, Roche-Seruendo LE, Cuesta Garcia C. Sensory Processing, Functional Performance and Quality of Life in Unilateral Cerebral Palsy Children: A Cross-Sectional Study. Int J Environ Res Public Health. 2020 Sep 28;17(19):7116. doi: 10.3390/ijerph17197116.
- Huang CY, Tseng MH, Chen KL, Shieh JY, Lu L. Determinants of school activity performance in children with cerebral palsy: a multidimensional approach using the ICF-CY as a framework. Res Dev Disabil. 2013 Nov;34(11):4025-33. doi: 10.1016/j.ridd.2013.08.022. Epub 2013 Sep 13.
- Bumin G, Kavak ST. An investigation of the factors affecting handwriting performance in children with hemiplegic cerebral palsy. Disabil Rehabil. 2008;30(18):1374-85. doi: 10.1080/09638280701673609.
- Assis-Madeira EA, Carvalho SG, Blascovi-Assis SM. Functional performance of children with cerebral palsy from high and low socioeconomic status. Rev Paul Pediatr. 2013 Jan-Mar;31(1):51-7. doi: 10.1590/s0103-05822013000100009. English, Portuguese.
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