Throughout growth and development, children with Cerebral Palsy (CP) progressively develop neuromusculoskeletal deficiencies. These deficiencies interfere with the ability and performance of activities and social participation, and it is of great importance to identify which are the most frequent deficiencies for adequate therapeutic planning.

To verify the frequency of the main neuromusculoskeletal deficiencies in children and adolescents with CP at different levels of the Gross Motor Function Classification System (GMFCS).

Observational and descriptive study. Forty-five children and adolescents diagnosed with (CP) between 3 and 18 years of age from all GMFCS levels were included. The research participants are patients from the neuropediatrics outpatient clinic of the University Hospital of Brasília. Two trained examiners performed a physical assessment of the participants and collected the following variables indicative of neuromusculoskeletal deficiencies, characterizing them as present or absent: equinovarus or valgus foot; decreased range of motion (ROM) or flexion stiffness of knee, elbow, and wrist joints; hip in wind. The percentage of migration (PM) of the hip was also evaluated through radiographic imaging, with the aid of the HipScreen application to calculate the percentage and using cutoff points to determine the presence or absence of hip subluxation and/or dislocation. Statistical analysis was performed using descriptive statistics.

45 children/adolescents participated, mean age 6.58 years, 62.2% male, 57.7% bilateral spastic, 31.1% classified at level IV of the GMFCS. The most prevalent deficiency was the equine foot, present in 73.3% of the participants, both present in 40% of the evaluated ones. Flexion stiffness of the knees (24.4%) and elbows (13.3%) was observed in children classified as levels III, IV and V of the GMFCS. Rigidity of the flexed wrist was found in 24.4% of the GMFCS II, IV and V children. Two GMFCS V participants had hips in windy conditions. The mean MP of the hip was 18.47 (±19.95), being lower in GMFCS I (4.50, ± 5.98) and becoming progressively higher with the increase in the GMFCS level, reaching 22. 95 (±32.75) in GMFCS V. It was observed that 35.5% of the sample had hip subluxation, distributed in levels II to V, while hip dislocation was present in 4.4% of the sample and only for the GMFCS V level.

Among the deficiencies analyzed, the equine foot affected the sample more homogeneously, and it is concluded that the GMFCS V level is the most affected by deformities in relation to the other levels, and it is important to highlight that children at this level tend to develop the hip dislocation.

The results allow us to infer that preventive interventions should be used in children and adolescents with CP, to avoid the emergence of the deficiencies and subsequent deformities, mainly the development of the equine foot.