Epidemiology of cerebral palsy in Brazil through the lens of the International Classification of Functioning, Disability and Health framework

AIM: To establish an overall description of people with cerebral palsy (CP) in Brazil, including the epidemiology, clinical features, functioning, and access to rehabilitation and equipment, through the lens of the International Classification of Functioning, Disability and Health (ICF) framework, using preliminary data from the Brazilian Cerebral Palsy Register (BrCPR). METHOD: Data were extracted from the ongoing BrCPR for individuals with CP aged 0 to 100 years. The information collected included aetiological risk factors and, from the ICF, personal and health-related factors, environmental factors, body functions and structures, activity, and participation. RESULTS: A total of 1098 participants were included (median age 9 years [interquartile range 5-15 years]; 57.6% male). Most brain injuries occurred pre- or perinatally (68.1%), with preterm birth (44.8%) and perinatal asphyxia (51.1%) being common risk factors. Postneonatal CP (>28 days) was often infection-related (23.0%). One-third of all children were diagnosed before 6 months of age. Bilateral spastic CP predominated (59.4%), and 54.9% were classified in Gross Motor Function Classification System levels IV or V. Co-occurring conditions included epilepsy (57.5%), hip dislocation (31.0%), and cognitive impairment (55.3%). Severe activity limitations were reported, for example dressing (58.9%). Considering participation, 10.0% never attended school. Among environmental barriers, 67.7% lacked home adaptations, 14.0% received no rehabilitation, and 44.7% lacked necessary assistive devices. INTERPRETATION: The BrCPR highlights substantial unmet needs among individuals with CP in Brazil.