Challenge of the Week / Pediatrics / 02.26.2021

An 8-year-old male patient with hemiplegic cerebral palsy who can walk up stairs without a railing was recently prescribed an ankle-foot orthosis to assist with foot clearance. He finds it useful for walking, but removes it for sports and physical education class. Which of the following best describes his Gross Motor Function Classification System (GMFCS) level?
    • He should be classified as a GMFCS level I since he can walk with or without braces
    • This is the definition of GMFCS level I
    • His GMFCS level is II because he is able to participate in physical activities and sports
    • Children of many levels can participate in physical activities
    • By requiring an ankle-foot orthosis, he has gone from a GMFCS level I to II
    • While his gait is optimized with the ankle-foot orthosis, his ability to ambulate without braces makes him a GMFCS level I
    • His GMFCS level is deteriorating and is likely to continue to change over the next few years
    • The GMFCS level is steady at level I


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