Doctors use a few different scales when looking at how cerebral palsy affects your body and life. It’s important to note that these scales aren’t progressive.
Cerebral palsy is a motor condition that affects your motor control. It can cause symptoms like difficulty running, walking, and performing daily tasks independently. However, symptoms of the condition can vary.
Some people with cerebral palsy have very mild symptoms and require minimal assistance, while others are unable to move around without assistive devices like powered wheelchairs.
A scale called the Gross Motor Function Classification System (GMFCS) classifies the levels of cerebral palsy and the effects to expect at each one.
There are multiple scales and systems that doctors use to classify cerebral palsy. For instance, it’s common for them to simply classify cerebral palsy as mild, moderate, or severe. However, this system provides very little specific information.
Additional systems measure cerebral palsy by how many regions of the body the condition affects or by how it affects your daily life function.
The GMFCS measures the motor skills and function of people with cerebral palsy. It provides a clearer picture than other systems and can help doctors and families discuss cerebral palsy symptoms and management.
The GMFCS divides cerebral palsy into five stages. Higher stages indicate higher needs and more severe cerebral palsy symptoms.
GMFCS stage 1
People who meet stage 1 GMFCS criteria:
- have decreased speed, balance, and coordination
- can walk independently
- can climb stairs and navigate hallways without railings or other assistance
GMFCS stage 2
People who meet stage 2 GMFCS criteria:
- need hand railings to climb staircases
- might be unable to walk long distances without mobility aids
- experience some difficulties with activities like running and jumping
- have trouble navigating uneven surfaces
GMFCS stage 3
People who meet stage 3 GMFCS criteria:
- can walk using assistive mobility devices while indoors
- can self-propel in a wheelchair while out and about for extended periods
- can sit and stand with minimal assistance
GMFCS stage 4
People who meet GMFCS stage 4 criteria:
- have difficulty walking even short distances using mobility devices
- primarily use wheelchairs to move around
- often need assistance with sitting and standing
- often need support while sitting
GMFCS stage 5
People who meet GMFC stage 5 criteria:
- can’t sit or stand independently
- have very restricted voluntary movement
- need support while sitting
- may be able to control a powered wheelchair
Cerebral palsy doesn’t get worse with age. The condition isn’t progressive. This means that symptoms don’t worsen throughout your life.
However, symptoms of cerebral palsy can change with age. For instance, it’s common for people with cerebral palsy to experience more pain linked to their condition once they become adults.
Additional symptoms that can appear in adulthood include:
The GMFCS is a useful tool for talking about how cerebral palsy affects your life. However, there are also additional systems, which your doctor may also use.
For instance, they might use this severity level classification:
- Mild: Mild cerebral palsy means you have limited symptoms and can move without assistance.
- Moderate: Moderate cerebral palsy means you may need medications, braces, or other forms of support to do daily tasks.
- Severe: Severe cerebral palsy means you need a wheelchair and have significant limits on your independence.
- No cerebral palsy: Doctors use this classification when a person has signs of cerebral palsy in infancy but never develops symptoms.
It’s also common for doctors to use topographical classifications. If they do, you’ll see or hear the suffixes “-plegia” or “-paresis.” These refer to severity. “Plegia” means paralyzed, while “paresis” means weakened. For instance, quadriparesis is weakness in all four limbs, while quadriplegia is paralysis in all four limbs.
Topographic classifications are as follows:
- Monoplegia (monoparesis): This is when cerebral palsy only affects one limb.
- Hemiplegia (hemiparesis): This is when cerebral palsy affects a leg and arm on a single side of the body.
- Diplegia (diparesis): This is when cerebral palsy affects your legs more than your arms.
- Paraplegia (paraparesis): This is when cerebral palsy affects your lower half.
- Triplegia (triparesis): This is when cerebral palsy affects three of your limbs.
- Quadriplegia (quadriparesis): This is when cerebral palsy affects all four of your limbs.
- Double hemiplegia (double hemiparesis): This is also when cerebral palsy affects all four of your limbs, but it affects one side of the body more than the other.
- Tetraplegia (tetraparesis): This is also when cerebral palsy affects all four of your limbs, but it affects three limbs significantly more than the fourth.
- Pentaplegia (pentaparesis): This is when cerebral palsy affects your head and neck as well as all four of your limbs.
You’re not alone
Lifelong conditions such as cerebral palsy can be challenging to manage. But you don’t have to take it on alone. Support and resources are available. For instance, you can check out:
- Cerebral Palsy Research Network (CPRN): The CPRN is dedicated to improving the lives of people with cerebral palsy and their families. They advocate for research, community programs, and more. You’ll also find community forums and a resource library on their site.
- United Cerebral Palsy (UCP): The UCP is a nonprofit with branches across the United States. They offer resources that can connect you with assistive technology, transportation, healthcare navigation, housing assistance, and more.
- Cerebral Palsy Foundation (CFP): You’ll find a wealth of resources with the CFP. They offer educational materials, advocacy, and more.
Cerebral palsy causes a wide range of effects. Some people can run and walk without any assistance, while others require assistive technology like powered wheelchairs for moving around.
The GMFCS helps classify the levels of cerebral palsy. People with lower GMFCS level cerebral palsy have fewer limitations and limits. People with higher GMFCS level cerebral palsy need more assistance, including adaptive technology and mobility aids.