Physiotherapeutic interventions and physical activity for children in Northern Sweden with cerebral palsy: a register study from equity and gender perspectives

Figures & data

Table 1. Description of gross motor function levels and merged groupings according to the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) used in this study.

Level GMFCS-E&R according to original scale		Merged levels
I	Walks without limitations	GMFCS-A
II	Walks with limitations
III	Walks using a handheld mobility device, uses manual wheel chair independently	GMFCS-B
IV	Self-mobility with limitations. May use powered mobility	GMFCS-C
V	Transported in a manual wheelchair

Table 2. Distribution of sex, age, GMFCS group, county council affiliation, receipt of botox treatment, medication for spasticity, surgery or wears orthotics, by sex.

Variable		Girls n = 141	(%^b) (45)	Boys n = 172	(%^b) (55)	Total N = 313
Age (years)	0–5	46	(44)	59	(56)	105
(n = 313^a)	6–11	68	(44)	86	(56)	154
	12–18	27	(50)	27	(50)	54
GMFCS-E&R	GMFCS-A	85	(47)	96	(53)	181
(n = 311)	GMFCS-B	10	(36)	18	(64)	28
	GMFCS-C	45	(44)	57	(56)	102
County Council	Norrbotten	14	(38)	23	(62)	37
(n = 313)	Västerbotten	28	(35)	52	(65)	80
	Västernorrland	35	(49)	37	(51)	72
	Jämtland	23	(54)	20	(47)	43
	Gävleborg	41	(51)	40	(49)	81
Botox (n = 291)	yes	35	(41)	51	(59)	86
Spast. med^c. (n = 290)	yes	22	(48)	24	(52)	46
Surgery (n = 313)	yes	20	(53)	18	(47)	38
Orthotics^d (n = 296)	yes	75	(46)	88	(54)	163
	training	25	(46)	29	(54)	54
	balance	52	(45)	64	(55)	116
	gait	18	(53)	16	(47)	34

^an varies depending on number of participants reporting on each variable.

^bPercentage refers to boys and girls in each row.

^cSpasticity reducing medication.

^dParticipants may have more than one reason for use of the orthotics.

Table 3. Distribution of GMFCS-group in percent in each age group. Chi2 (p = 0.031).

Age group	n	GMFCS-A	GMFCS-B	GMFCS-C
0–5	105	61 %	7 %	27 %
6–11	154	62 %	10 %	27 %
12–18	54	42 %	9 %	50 %
Total (n)	313	181	28	102

Table 4. Rate of participants (%) who responded yes in variables concerning physiotherapy interventions and physical activity by sex, age group and GMFCS group.

Intervention/activity	Sex			Age-group				GMFCS-group
(n)	F %	M %	p-value	0–5 %	6–11 %	12–18 %	p-value	A %	B %	C %	p-value
PTI yes (248)	89	79	0.016^x	88	82	87	0.42	75	100	96	<0.001^x
PTI often (149)	54	68	0.025^x	65	62	58	0.72	58	67	66	0.45
PT^a present often (93)	39	38	0.95	46	31	46	0.068	29	48	50	0.005^x
Intensive training (47)	17	17	0.98	11	19	21	0.21	17	30	13	0.11
Factors aimed to improve by PTI:
Strength (197)	68	73	0.34	75	67	75	0.33	62	96	78	<0.001^x
Tone (145)	49	57	0.20	57	49	58	0.38	42	80	66	<0.001^x
Joint mobility (242)	85	88	0.51	88	86	85	0.85	80	96	95	0.002^x
Postural ability (200)	71	74	0.50	81	67	74	0.57	66	89	81	0.006^x
Aerobic capacity (116)	48	39	0.15	36	43	54	0.12	42	58	40	0.25
Body awareness (124)	43	49	0.29	54	41	47	0.14	38	46	61	0.002^x
Respiration (51)	22	17	0.31	17	14	36	0.003^x	9	13	38	<0.001^x
Pain (37)	16	12	0.35	9	12	29	0.003^x	12	13	19	0.31
Leisure act YES (177)	57	56	0.77	45	63	61	0.011^x	65	57	42	0.001^x
Leisure act Often (78)	79	74	0.52	66	80	79	0.27	81	71	66	0.24
Phys edu^b Often (198)	88	96	0.028^x		94	93	0.20	93	96	87	0.29

^xP < 0.05 are considered significant.

^aPhysiotherapist.

^bPhysical education.

Table 5. Rate of participants (%) who responded yes in variables concerning physiotherapy interventions and physical activity by county council.

	County council
Intervention/activity (n)	Norrbotten %	Västerbotten %	Gävleborg %	Jämtland %	Västernorrland %	p-value
Received PTI (248)	92	95	70	88	82	<0.001^x
Received PTI often (149)	90	84	15	68	56	<0.001^x
PT^a present often (93)	44	37	32	29	50	0.23
intensive training (47)	9	23	17	21	11	0.19
Factors aimed to improve by PTI:
Strength (197)	95	74	44	71	77	<0.001^x
Tone (145)	92	47	40	33	62	<0.001^x
Joint mobility (242)	92	95	68	90	86	<0.001^x
Postural ability (200)	95	87	49	68	66	<0.001^x
Aerobic capacity (116)	68	41	26	21	59	<0.001^x
Body awareness (124)	81	65	9	32	45	<0.001^x
Respiration (51)	41	20	0	16	24	<0.001^x
Pain (37)	35	11	4	5	20	<0.001^x
Leisure activity YES (177)	60	65	47	63	53	0.16
Leisure act. Often (78)	75	68	72	79	89	0.39
Phys edu^b often (198)	96	92	87	90	96	0.44

^xp-values <0.05 is considered significant.

^aPhysiotherapist.

^bPhysical education.

Table 6. Odds ratios (OR) and 95 % confidence interval (95 % CI) from univariate and multivariate logistic regression for associations between receiving physiotherapy interventions, county council affiliation and sex.

Variable	Participants (n = 293)	OR Univariate	CI (95 %)	OR Multivariate	CI (95 %)
Sex
Girls	134	1		1
Boys	159	2.2	1.2–4.2	1.9	1.0–3.8
County Council
Gävleborg	69	1		1
Norrbotten	36	4.8	1.3–17.5	4.5	1.2–16.3
Västerbotten	80	8.3	2.7–25.7	7.5	2.4–23.5
Västernorrland	66	2.0	0.9–4.4	1.9	0.9–4.4
Jämtland	42	3.2	1.1–9.4	3.3	1.1–9.7

Table 7. Odds ratios (OR) and 95% confidence interval (95% CI) from univariate and multivariate logistic regression analyses for associations between ‘physiotherapy interventions often’, county council affiliation and sex.

Variable	Participants (n = 240)	OR Univariate	CI (95 %)	OR Multivariate	CI (95 %)
Sex
Girls	102	1		1
Boys	138	1.9	1.1–3.1	1.8	0.9–3.3
County Council
Västernorrland	53	1		1
Norrbotten	31	52.5	12.8–214.7	52.5	12.7–216.1
Västerbotten	75	29.5	11.2–78.1	28.7	10.8–76.3
Jämtland	38	12.2	4.4–33.7	12.8	4.6–35.7
Gävleborg	43	7.1	2.7–18.6	7.1	2.7–18.8