Physical Strain: A New Perspective on Walking in Cerebral Palsy

Balemans, Astrid C. J.; Bolster, Eline A. M.; Brehm, Merel-Anne; Dallmeijer, Annet J.

doi:10.1016/j.apmr.2017.05.004

Cited by 21 publications

(15 citation statements)

References 24 publications

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“…The resulting pain or increased energy requirements may explain why a preference for another form of mobility (e.g. wheelchairs) may subsequently arise [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The use and perception of support walkers for children with disabilities: a United Kingdom survey

2020

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Background Support walkers are a type of assistive device that may enable non-ambulant children with disabilities to walk independently and promote improvements in bowel function, bone mineral density (BMD), mobility, independence, participation and social function. However, there is little evidence to support these benefits and there is a lack of research describing the use of support walkers in clinical practice. This study aimed to examine the use of support walkers for children with disabilities in clinical practice. Method A survey was distributed via professional organisations, charities and schools associated with paediatric disabilities in the UK. Participants were recruited between January and March 2018. Populations of interest were those who prescribe support walkers to children with disabilities and those who work with children who use them. Results In total, 125 people were included in the analysis; 107 responders prescribed support walkers and 18 responders worked with children who used support walkers. The population of children who use support walkers ranged from 6 months to 18 years and included children with cerebral palsy, chromosomal abnormalities and other medical conditions. Use of these devices was also reported in schools, at home and in the community for varying lengths of time. Numerous perceived benefits were noted, most frequent of which were increases in physical activity and enjoyment. By comparison, fewer perceived problems were identified but centred on lack of space and difficulty with transfers. Conclusions This study provides insight into the use of support walkers in the UK, particularly surrounding current practices, which may help to improve consistency in clinical settings. Perceived benefits and problems may provide a basis for identification of appropriate outcome measures to monitor effectiveness. These results should also provide a basis for designing future studies to examine effectiveness of support walkers for paediatric disabilities.

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“…The resulting pain or increased energy requirements may explain why a preference for another form of mobility (e.g. wheelchairs) may subsequently arise [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The use and perception of support walkers for children with disabilities: a United Kingdom survey

2020

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“…In the current study, the GMFCS level III group was the only one to exhibit a decrease in total FISSA score, albeit non-significant. As mentioned in the study of McPhee et al (3) and also in the study above (22), it is likely that those who function at GMFCS level III and use arm crutches and/or a manual wheelchair may experience greater fatigue. However, GMFCS level III is a subgroup of individuals with a great variation in mobility, depending on their physical abilities and personal/environmental factors.…”

Section: Gmfcs IIImentioning

confidence: 89%

Fatigue in adults with cerebral palsy: A three-year follow-up study

Lansink¹,

McPhee²,

Brunton³

et al. 2018

J Rehabil Med

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People with cerebral palsy are often tired and may complain about fatigue. In this study we describe the development of fatigue over a mean period of 3 years. We found that fatigue is more or less stable over time on a group level. On an individual level there can be important changes, both increases and decreases in fatigue-related symptoms. We did not find any known risk factors for fatigue (for example body mass index, age) to be predictive of change in fatigue over time. We learned that adults with CP, who experience fatigue, are likely to remain fatigued in the future. We therefore think it is important for care providers to monitor and talk about fatigue with adults with CP. We would suggest care providers begin this discussion at a much younger age to influence fatigue later in life. Objectives: To describe the course of fatigue over a 3-year follow-up period in adults with cerebral palsy and to investigate the association of known determinants of fatigue (i.e. demographic characteristics and/or body composition) with change in fatigue. Methods: Forty-one adults with cerebral palsy from a previous study of fatigue were invited to participate in a follow-up study. Twenty-three adults with cerebral palsy (Gross Motor Function Classification System (GMFCS) levels I-V; mean age 38 years 2 months, standard deviation (SD) 14 years 1 month)) agreed to participate (convenience sample). Fatigue was measured with the Fatigue Impact and Severity Self-Assessment (FISSA, range 31-157) questionnaire. The course of fatigue is described at group, subgroup (GMFCS) and individual levels. Results: The mean FISSA score for all participants was 84.0 (SD 27.7) at baseline and 91.7 (SD 26.7) at follow-up. Despite variations among individuals in the change of fatigue, there was no statistically significant difference in FISSA score over time (p = 0.087, 95% confidence interval (95% CI)-16.7 to 1.22). No known determinants of fatigue predictive of change in FISSA scores were found. Discussion: Fatigue appears to be relatively stable within adults with cerebral palsy over time, with a variable presentation between individuals and across GMFCS levels. Care providers should monitor and discuss fatigue in young individuals with cerebral palsy in order to attenuate fatigue later in life.

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“…This is an adaptation process that might take more time than the current intervention allowed for. A study of walking children and adolescents with CP and controls, concluded that the strain from walking, close to or above anaerobe threshold for many, might explain fatigue (75). This type of strain is probably present for adults as well.…”

Section: Discussionmentioning

confidence: 99%

A Mindfulness-Based Stress Reduction Program via Group Video Conferencing for Adults With Cerebral Palsy – A Pilot Study

et al. 2020

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Purpose: Adults with cerebral palsy experience challenges related to lifelong disability, such as stress, fatigue, pain and emotional issues. E-health services can be delivered regardless of residence and level of functioning. The aim of this pilot study was to explore the potential benefits and feasibility of a mindfulness-based program delivered to adults with cerebral palsy via group video conferencing. Methods: Six adults with cerebral palsy received an 8 week mindfulness group-based program via video conferencing. A multiple single-case study design was applied, including quantitative and qualitative elements. Pain was assessed 16 times through the study period. Questionnaires were administered to gather data on pain catastrophizing, stress, fatigue, emotional distress, positive and negative affect, and quality of life. A focus group interview addressed experiences with the intervention and the mode of delivery. Results: The participants' pain levels showed varied trajectories. Pain catastrophizing and negative affect were statistically significant decreased. Qualitative data indicated benefits from mindfulness in coping and stress management. The video conferencing delivery was evaluated as feasible, with no major adverse effects. Conclusion: Since the pilot study had a small sample size, potential treatment benefits should be interpreted with caution. However, this pilot study provides important information in the planning of future larger and controlled studies on mindfulness-based interventions programs via video conferencing for adults with cerebral palsy and other persons living with long-term disability.

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Physical Strain: A New Perspective on Walking in Cerebral Palsy

Cited by 21 publications

References 24 publications

The use and perception of support walkers for children with disabilities: a United Kingdom survey

The use and perception of support walkers for children with disabilities: a United Kingdom survey

Fatigue in adults with cerebral palsy: A three-year follow-up study

A Mindfulness-Based Stress Reduction Program via Group Video Conferencing for Adults With Cerebral Palsy – A Pilot Study

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