Classifying Cerebral Palsy

Each year, the Journal of Pediatric Orthopaedics publishes more papers dealing with orthopaedic issues of children with cerebral palsy (CP) than any other medical journal. However, it can sometimes be difficult for the reader to understand the defining features of the study population. Different authors use different terms, and the definitions of the terms are imprecise. CP is traditionally classified by motor type and topographical distribution. A classification based on motor type might include the terms spastic, dyskinetic, ataxic, hypotonic, and mixed. The most commonly used terms in classifications of topographical distribution are hemiplegia, diplegia, and quadriplegia, but the terms monoplegia, paraplegia, triplegia, double hemiplegia and tetraplegia are also used. The terms vary considerably, but more importantly classifications by motor type and topography 4 are known to be unreliable. What can contributors to JPO do to improve communication? The answer is to add a simple, valid, and reliable classification of gross motor function in their clinical research. For some time, orthopaedic surgeons have recognized that the incidence of certain musculoskeletal problems and the success rate of reconstructive surgery in CP are related to severity. For example, 2 many studies suggest that the incidence of spastic hip disease is directly related to functional severity. Other studies report