Kinematic classification

Abstract

Cerebral palsy (CP) is considered a persistent but not unchangeable disorder of movement and posture; therefore, the definition given 50 years ago by Ingram (1955) and Mac Keith & Polani (1959), and subsequently divulged by Bax (1964), is still accepted as valid. In fact, also ad hoc international commission has recently reaffirmed the concept: CP is a disorder of development of posture and movement (Bax et al. 2005). In order to be consistent with this definition, the only way to classify CP would be through an analysis of posture and movement (intended from the kinesiological point of view as gesture), assessed in terms of quality (type) and of quantity (measure) (Ferrari, 1995). Actually, the most popular criterion to classify CP has always been based on the topographic (geographic) distribution of the motor impairment: tetraplegia (quadriplegia), diplegia, hemiplegia, with minor variations to these macro-categories: paraplegia, double hemiplegia, triplegia, monoplegia, reversed diplegia. Taxonomically, no importance is usually given to the location of the brain lesion (internal capsule, basal nuclei, semi-oval centre, cerebellum, etc.), to the timing of the central nervous system (CNS) damage (pre-, peripost-natal) with the exception of hemiparetic forms (see chapter 16), to the etiology (prematurity, dystocia, neonatal asphyxia, intracranial hemorrhage, meningoencephalitis, etc.), to pathogenesis (traumatic, toxic, infective), to CNS lesion extent, which can today be quantified by neuroimaging (see chapter 3), to neurological deficits associated with palsy and their syndromic combination (epilepsy, mental retardation, sensorial deficiency, perceptive disorders, dysphonia, dysarthria, learning disabilities, behavior disorders, etc.), to both primitive and secondary associated signs and symptoms, and to their origin. © 2010 Springer-Verlag Milan.