Children with Cerebral Palsy (CP) need to be assessed carefully to establish the intensity of impairment before any therapy is initiated. For the first time, a new and innovative testing tool has been developed by doctors that gauges the improvement in patients with CP — a disorder caused due to brain damage.
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So far tools like Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS) and Bimanual Fine Function (BFMF) were used to evaluate a patient with Cerebal Palsy. There were, however, limitations as it did not assess certain parameters that are essential to be evaluated in the patients with CP which include epilepsy, hearing, drooling, writing, mathematical skills, communicating and playing. Also, distinction between first two levels of GMFCS is unclear, mainly for children below the age of 2 years.
Developed by Dr Geeta Shroff, a New Delhi based gynaecologist, the new study tool, Nutech Functional Score (NFS), tracks over 32 parameters to provide accurate assessment of the progress of the disease as compared to the existing method of screening. The result of this new study tool has been published in the International Archives of Medicine (June, 2015), an open access international medical science and clinical practice journal.
Shroff told The Indian Express that NFS is a 32 point positional and directional scoring system that can assess the CP symptoms that remain far from assessment in GMFCS: Feeding, indication, epilepsy, toilet training, drooling, mathematical skills, hearing, vision, commands, smiling, constipation, recognition /awareness, eye contact, aggression, speech, breathing difficulty, defense mechanism and swallowing. As opposed to GMFCS, NFS scoring system can be used to assess patients aged above 18 years. We have also converted the scores into numeric grades, Shroff explained.
The new tool also has the advantage of revealing even the slightest improvement in CP patients. “The other advantage of using NFS is that scoring is numeric which means grades can be added or subtracted, thus revealing even the slightest improvement in the patient. While NFS tells the condition of a case from bad to good, GMFCS (a single score assigned on the basis of age and motor function) classifies CP into five levels from good to bad,” added Shroff.
Cerebal Palsy is a non-progressive disorder that occurs as a result of the damage to the brain of a foetus and newborns. Its signs and symptoms, such as spastic muscles, poor balance and gross motor delays remain lifelong and patient is subject to life with limitations. It is estimated to affect 3 per 1000 live births in India.
Shroff is the founder and medical director of Nutech Mediworld, a facility that provides human embryonic stem cell therapy.