Physical Examination for CP Patients

Body Weight
Determine the body weight. Foreseeable changes, like a weight gain due to growth, should be taken into consideration.

Body Height
Determine the body height. Foreseeable changes, like a change in height due to growth, should be taken into consideration.

Activity Level
Evaluate the activity level together with your patient while already taking foreseeable changes into consideration.

1. Indoor Walker
Activity level 1 corresponds to GMFCS level 4 and FMS level 2 Activity level 1 of the FIOR & GENTZ classification corresponds to level 4 of the GMFCS classification and to level 2 of the FMS classification. Both classification levels are described more detailed in the following.
GMFCS Level 4:
Patients can only walk with walking aids. They use a walker without help from another person. For climbing stairs they have to hold onto a railing and require help from another person. They can only walk with walking aids over long distances.
FMS Level 2:
Patients use a walker in addition to an orthosis in order to be able to walk without help from another person.

2. Restricted Outdoor Walker
Activity level 2 corresponds to GMFCS level 3 and FMS level 3 Activity level 2 of the FIOR & GENTZ classification corresponds to level 3 of the GMFCS classification and to level 3 of the FMS classification. Both classification levels are described more detailed in the following.
GMFCS Level 3:
Patients can only walk with walking aids. They use a walker without help from another person. For climbing stairs they have to hold onto a railing and require help from another person. They can only walk with walking aids over long distances.
FMS Level 3:
Patients use canes/crutches in addition to an orthosis in order to be able to walk without help from another person.

3. Unrestricted Outdoor Walker
Activity level 3 corresponds to GMFCS level 2 and FMS level 5 Activity level 3 of the FIOR & GENTZ classification corresponds to level 2 of the GMFCS classification and to level 5 of the FMS classification. Both classification levels are described more detailed in the following.
GMFCS Level 2:
Patients are usually able to walk without walking aids. For climbing stairs they have to hold onto the railing with one hand. Running, jumping, long distances, uneven terrain and crowded areas trouble the patients.
FMS Level 5:
Patients use no devices in addition to an orthosis and do not need any help from another person in order to be able to walk. For climbing stairs they have to hold onto the railing with one hand.

4. Unrestricted Outdoor Walker with Especially High Demands
Activity level 4 corresponds to GMFCS level 1 and FMS level 6 Activity level 4 of the FIOR & GENTZ classification corresponds to level 1 of the GMFCS classification and to level 6 of the FMS classification. Both classification levels are described more detailed in the following.
GMFCS Level 1:
Patients do not need any walking aids. Running, jumping as well as climbing stairs without the use of a railing do not pose a problem.
FMS Level 6:
Patients use no devices in addition to an orthosis and do not need any help from another person to be able to walk. They can walk on any terrain and in a crowded area.

Gait Type
Determine the patient's gait type according to the Amsterdam Gait Classification.