The relationship between gross motor function and psychological well-being in adults with cerebral palsy.

Timmins, Monica Clare
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Motor deficits are debilitating in that they affect everyday function in human beings (Zillmer & Spiers, 2001). Cerebral Palsy (CP) is one particular disorder that is primary characterised by motor deficits, more specifically gross motor function deficits. As a result, people with CP are restricted in their everyday function and lack independence and self-sufficiency. With other factors such as stigmatisation and prejudice, social participation becomes limited which leads to isolation and loneliness, which may further lead to psychological disorders such as depression, anxiety, low self esteem and poor quality of life. These assumptions are based on the application of the mental health model, and one could assume the poorer the level of functioning the more likely a person’s psychological well-being will suffer. Thus, the study attempted to investigate these assumptions by exploring the relationship between levels of gross motor function and psychological well-being. A sample of 43 participants based in a care centre in Johannesburg completed a demographic questionnaire, the Major Depression Inventory (MDI), The Becks Anxiety Inventory (BAI), The Rosenburg Self Esteem Scale (RSE) and the Comprehensive Quality of Life Scale (COMQOL – A5). In addition, through observation, the level of gross motor function was determined by utilising the Gross Motor Function Classification System (GMFCS). The data that was gathered and was statistically manipulated to explore three main questions. Before the relationship between gross motor function and psychological well-being could be explored it was necessary to examine the suitability of the use of psychological measure on an adult with CP sample. Results indicated that the MDI (r = 0.78), BAI (r = 0.76). RSE (0.77), and COMQOL (r = 0.99) had high internal constancy reliability. The relationship between demographical variables, namely, age, gender, years of residency, experience of motor deterioration and presence of epilepsy, were tested against the level of gross motor function. No significant results were found apart from motor PDF created with pdfFactory trial version 4 deterioration. More participants with a higher level of gross motor function experienced motor deterioration (77%) than those with a lower level of gross motor function (44%). Lastly, the relationship between psychological variables and gross motor function was investigated as well as difference between the levels. Correlations revealed very weak positive relationships, with the exception of depression having a very weak negative relationship. All relationship were non significant. Although slight differences were seen between levels, they were non significant. 7% of participants were diagnosed with depressive disorders, and 47% with anxiety disorders. Problems with certain questions pertaining to the BAI raised concerns over the suitability of its use in CP adult samples. The study concluded that psychological measures, excluding the BAI, were suitable for use on a sample of adults with CP. It also highlighted that the level of motor functioning is not related to or determines psychological well-being in adults with CP. PDF created with pdfFactory trial version
Cerebral palsy , Gross motor function