Children with cerebral palsy (CP) are at risk of developing musculoskeletal problems such as muscle contractures, displacement of the hip and scoliosis. Hip dislocation leads to pain, decreased function and increased difficulties with personal care. The prevalence of hip displacement is directly related to gross motor function as determined by the Gross Motor Function Classification System (GMFCS).
The prevalence of hip displacement rises according to the severity of the CP. Children who are GMFCS Level 1 have virtually no incidence of hip displacement whereas for children at Level V it is 90%. Evidence has shown that hip dislocation in CP is potentially preventable by patients having regular, standardised physical and radiological assessments. This, in turn, allows the early identification of hip displacement and timely intervention.
Monitoring and preventing progressive hip displacement has been the main aim of established hip surveillance programmes in other countries. In Sweden and Australia the incidence of hip dislocation has significantly reduced by earlier intervention after the introduction of the surveillance programmes.
Cerebral Palsy Integrated Pathway Scotland (CPIPS) has been implemented in Scotland as a pathway for a nationally agreed protocol of standardised musculoskeletal examination for children with CP to ensure equity throughout Scotland. It is based on best practice guidelines from Sweden and Australia and meets the principles of care recommended in the 2012 NICE Clinical Guideline ‘Spasticity in children and young people with non-progressive brain disorders’.
APCP is campaigning to suport the introduction of this pathway across the UK.
The CPIPS DVD contain documents and videos to support the implementation of CPIPS and includes full details of the standardised assessments involved.