Year of Publication


Degree Name

Master of Science (MS)

Document Type

Master's Thesis




Kinesiology and Health Promotion

First Advisor

Dr. Michael Pohl


INTRODUCTION: Cerebral Palsy (CP) is the most common disabling motor disorder found during childhood, occurring in 2.1-3.2 of every 1,000 births. Motor functionality of children with CP is commonly compromised and is classified with a gross motor function classification score (GMFCS) and with the gross motor function measure (GMFM). Balance ability has typically been assessed using single leg stance test (SLST) time but more recently, center of pressure excursion (COPE) has shown to be a more valid measurement in populations with altered motor abilities. However, COPE has not been used to test balance in the CP population, yet. This study aimed to determine if relationships were present between COPE measurements, functionality measurement scores (GMCS and GMFM) and reported fall frequency. It was hypothesized that i) larger COPE measurements would be associated with a higher GMFCS level and lower GMFM score, and that ii) COPE measurements would be significantly higher in children with a high reported incidence of fall frequency. METHODS: Gross functionality was measured using a GMFM score and GMFCS level. Balance ability was assessed using COPE measurements on a force plate and SLST time. Fall frequency was determined by a short questionnaire. A Pearson correlation analyzed COPE measurements vs. mean GMFM score. A one-way ANOVA was used to compare COPE measures between GMFMCS levels, with a Bonferroni post-hoc test. Lastly, an independent sample t-test analyzed differences in COPE measurements and SLST time between fall frequency groups. RESULTS: Significantly larger COPE velocities were demonstrated in children who reported a greater number of falls in the past month and were considered high risk for falling (p = 0.02). No relationships were demonstrated between COPE measurements and GMFM score. GMFCS level III participants demonstrated statistically significant lower COPE velocity compared to GMFCS level II participants (p = 0.05). There were no significant differences in SLST between high and low risk fall groups (p = 0.07). DISCUSSION: Children with higher reported fall frequencies demonstrated a 60% increase in COPE velocity, compared to those with little to no falls. Clinical GMFM scores did not demonstrate significant correlations to COPE measurements and may not be an appropriate identifier for falling in children diagnosed with CP. This is the first trial to evaluate COPE measurements and reported fall frequencies in children diagnosed with CP. The use of a force plate to determine COPE velocity during a SLST is useful in identifying children with CP who may be at an elevated risk for experiencing a fall. COPE velocity was able to provide intricate quantitative data regarding fall risk that could not be obtained during a normal SLST.

Digital Object Identifier (DOI)