Descriptions of functioning and health and relations to a gross motor classification in adults with cerebral palsy

Sandström, Karin; Alinder, John; Öberg, Birgitta

doi:10.1080/09638280410001703503

Cited by 97 publications

(96 citation statements)

References 26 publications

(29 reference statements)

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“…Gross motor functioning was classified according to the GMFCS, which is a five-level classification system grading severity of gross motor limitations 25 and is reliable and valid in adults with CP. 26 Neuromotor abnormality, 27 distribution of limb impairment (diplegia or quadriplegia), and spasticity were determined. Spasticity was assessed in four muscle groups of the lower limbs (hip adductors, hamstrings, rectus femoris, and gastrocnemius) using the Tardieu Scale.…”

Section: Demographic and Cp-related Characteristicsmentioning

confidence: 99%

Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy

Slot

Nieuwenhuijsen

Berg-Emons

et al. 2012

Develop Med Child Neuro

157

153

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AIM To investigate the prevalence and co-occurrence of chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy (SBCP) and explore associations of chronic pain and fatigue with depressive symptoms and daily functioning.METHOD Fifty-six adults with SBCP without severe cognitive impairment participated (35 males, 21 females; mean age 36y 5mo, SD 5y 10mo; Gross Motor Function Classification System level I [13], II [28], III [11], IV [4]). Chronic pain (>3mo), severity and nature of fatigue (Fatigue Severity Scale; Multidimensional Fatigue Inventory), and depressive symptoms (Center for Epidemiological Studies Depression Scale) were assessed. Associations were explored using multivariable logistic regression analyses. RESULTSThe study sample had a higher prevalence of chronic pain (75% vs 39%; p<0.001), mean fatigue (Fatigue Severity Scale, 4.4 [SD 1.3] vs 2.9 [SD 1.1]; p<0.001), and prevalence of depressive symptoms (25% vs 12%; p=0.004) than Dutch healthy reference samples. Chronic pain and severe fatigue co-occurred in 34% and in combination with depressive symptoms in 16% of the participants. Severity of fatigue was associated with depressive symptoms (OR 3.38; p<0.01). Chronic pain and fatigue were not associated with limitations in daily functioning.INTERPRETATION These findings suggest that adults with SBCP are severely affected by chronic pain, fatigue, and depressive symptoms, in addition to their spastic paresis.Pain and fatigue are common symptoms in adults with cerebral palsy (CP). [1][2][3][4] In CP, pain often begins at an early age and frequently becomes a chronic condition. 1,2,4 At least 67% of adults with CP in the USA experience chronic pain. 4 Fatigue is a well-known symptom in various neurological disorders, but is rarely studied in CP. 3,5,6 In a Norwegian study 3,7 the prevalence of fatigue was higher in adults with CP (30%) than in the general population (22%).Pain and fatigue are also common symptoms in the general population 8,9 and often co-occur, especially when they are severe. 8 In the general population, pain and fatigue have been shown to have an impact on daily activities 9 and to be associated with psychological distress, negative mood, and depression. 8,10 For the impact of pain and fatigue on daily activities in CP, Schwartz et al. 4 found that adults with CP tended to report only minor interference from pain on their activity level and social or work functioning, whereas Jahnsen et al.2,3 demonstrated that one-third of their CP sample reported a moderate to extreme impact of pain in daily life and an association of fatigue with limitations due to physical health problems. In a study among children with CP, pain and fatigue were associated with lowered school functioning and, in some cases, partly explained the association between severity of CP and performance at school. 5 Very little has been reported about depression in adults with CP. Jensen et al. 11 found that in adults with CP experiencing chronic pain at least 42% had depressive symp...

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Section: Demographic and Cp-related Characteristicsmentioning

confidence: 99%

Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy

Slot

Nieuwenhuijsen

Berg-Emons

et al. 2012

Develop Med Child Neuro

157

153

View full text Add to dashboard Cite

show abstract

“…The expanded and revised version of the Gross Motor Classification System has been developed for children with cerebral palsy with the oldest age band 12-18 years, but some studies have shown validity and reliability for use of this classification in adults with cerebral palsy as well. [22][23][24] According to this classification, individuals at levels I and II can walk and stand unsupported. The highest level of the Posture and Postural Ability Scale is to move into and out of position and therefore the assessment tool was not expected to differ between gross motor function levels I and II in postural ability.…”

Section: Discussionmentioning

confidence: 99%

Interrater reliability and construct validity of the Posture and Postural Ability Scale in adults with cerebral palsy in supine, prone, sitting and standing positions

et al. 2012

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Objective: To evaluate reliability, internal consistency and construct validity of the Posture and Postural Ability Scale for adults with cerebral palsy. Design: Psychometric evaluation of a clinical assessment tool. Setting: Rehabilitation centres in Sweden and Iceland. Subjects: Thirty adults with cerebral palsy aged 19-22 years, six people at each level I-V of the Gross Motor Function Classification System. Main measures: The Posture and Postural Ability Scale contains a 7-point ordinal scale for postural ability in supine, prone, sitting and standing, and items for assessment of posture. Posture and postural ability was rated from photos and videos by three independent assessors. Interrater reliability was calculated using weighted kappa. Internal consistency was analysed with Cronbach's alpha if item deleted and corrected item-total correlation. Construct validity was evaluated based on known groups, using Jonckheere Terpstra for averaged values of the three raters relative to the Gross Motor Function Classification System. Results: There was an excellent interrater reliability (kappa = 0.85-0.99) and a high internal consistency (alpha = 0.96-0.97, item-total correlation = 0.60-0.91). Median values differed (P < 0.02) between known groups represented by the levels of gross motor function, showing construct validity for all items. 83Conclusion: The Posture and Postural Ability Scale showed an excellent interrater reliability for experienced raters, a high internal consistency and construct validity. It can detect postural asymmetries in adults with cerebral palsy at all levels of gross motor function.

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“…For all 50 participants, the following data were gathered from their personal history: sex, age, clinical diagnosis according to the SCPE classification, 10 severity according to the GMFCS, 11,12 estimated intellectual status according to educational level, personal history data, health insurance company, and the number of inhabitants in their community. Ethical approval was obtained by the ethics commission of the Ludwig Maximilian University, Munich, Germany.…”

Section: Methods Samplementioning

confidence: 99%

Subjective well‐being and satisfaction with life in adults with spastic cerebral palsy: a pilot study of a randomized sample

Hergenröder¹,

Blank

2009

Develop Med Child Neuro

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The aim of this study was to explore subjective well‐being and satisfaction with life in general and with participation, activities, and health, in adults with cerebral palsy (CP). A randomized sample of 50 individuals was drawn from a sample of 465 previous outpatients of a regional social paediatric centre in southern Germany. A psychological measure for well‐being (Bern Questionnaire on Subjective Well‐Being, adult form [BSW/A]) and a sociomedical measure (Life Satisfaction Checklist [LiSat‐11]) were applied as outcome measures. Twenty‐five individuals from 35 responders (nine males, 16 females; mean age 28y, SD 2y 7mo, range 25–33y) were evaluated completely. Nineteen participants had bilateral and six had unilateral spastic types of CP (Gross Motor Function Classification System Levels I n=5, II n=5, III n=5, IV n=8, and V n=2). Eighteen individuals had no or only minor intellectual disabilities. Subjective well‐being and general satisfaction with life were not impaired in adults with CP. Joy of life (a subscale of the BSW/A) was even increased. Satisfaction with some areas of participation was reduced compared with a reference and clinical samples from Sweden. In conclusion, subjective well‐being and general satisfaction with life are not decreased in adults with CP. The different levels of satisfaction with areas of participation in German and Swedish individuals with CP may be explained by differences of social inclusion.

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Descriptions of functioning and health and relations to a gross motor classification in adults with cerebral palsy

Cited by 97 publications

References 26 publications

Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy

Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy

Interrater reliability and construct validity of the Posture and Postural Ability Scale in adults with cerebral palsy in supine, prone, sitting and standing positions

Subjective well‐being and satisfaction with life in adults with spastic cerebral palsy: a pilot study of a randomized sample

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