Sonja Mensch

113 The relationship between motor abilities and quality of life BACKGROUND Ingeneral,motor abilities play a very important role in independent functioning (Janssen et al. 2010). Adequate motor function in people with motor disabilities contributes to a sense of independence and autonomy, and improves the level of participation in daily life (Raz-Silberger et al. 2015; Badia et al, 2014; Schoenmakers et al. 2005). In childrenwith severemultiple disabilities (SMD), motor abilities are severely compromised, comparable with Gross Motor Function Motor Classification System (GMFCS) level IV/V (Palisano et al. 1997). They are often wheelchair-bound and dependent on their social, instrumental and material environment for all activities of daily life. In addition, children with SMD have a profound or unspecified intellectual disability (IQ<25) (American Psychiatric Association (APA). 2013). Communicative functions are severely limited; children with SMD only communicate non-verbally or through body language. Furthermore, Mensch et al., (Mensch et al. 2015c) reported that these children have sensory disorders such as visual impairment and other co-morbidity such as feeding and respiratory problems, epilepsy and contractures. Several studies found a relationship between motor functioning and QoL. In a study of Dickinson et al. on self-reported quality of life of 8–12-year-old children with cerebral palsy (N=500, GMFCS IV-V 14%, IQ<70 27%) severely limited self-mobility was found to be significantly associated with reduced mean score for physical well- being (Dickinson et al. 2007). In a systematic review of Tsoi et al. some positive effect was identified of certain medicinal and motor control interventions on quality of life in children with cerebral palsy (N=347, average age 9.1) (Tsoi et al. 2012). Badia et al. found in their study on pain, motor function and health related quality of life in 91 children (age 8-19Y, GMFCS level IV-V 51,6%, severe cognitive impairment 30,8%) that motor impairment scores were significantly positively associated with physical and autonomy domains of quality of life (Badia et al. 2014). Maher et al. found a positive association between physical activity, social and physical quality of life, and happiness in young people with cerebral palsy (N=70, mean age 13y, GMFCS level IV-V 16%) (Maher et al. 2016). We found one study in people with SMD (N=49, average age 23.7 SD12.2) where Petry et al. (2009) studied the association between QoL, motor function, personal characteristics and characteristics of care settings. They found characteristics of the medical conditions of the children turned out to be most strongly associated with the QOL-PMD scores. In their study other personal characteristics such as age, gender, motor limitations and sensory limitations were not found significantly related to the QOL-PMD scores. In addition, there is some limited evidence that impaired motor abilities will impact quality of life (QoL). We hypothesize this might be especially true in children with SMD, whose motor abilities are severely limited. By improving their motor abilities