Secondary Conditions of the Musculoskeletal System in Adolescents and Adults with Cerebral Palsy

Gajdosik, Carrie; Cicirello, Nancy

doi:10.1080/j006v21n04_04

Cited by 86 publications

(14 citation statements)

References 39 publications

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“…These types of items may inflate scores when used with people who are in poor health or aging or who have a disability. Scores are used to generate the following diagnoses: nondepressed [0-5], clinically significant symptomatology [6][7][8][9][10], and probable major depression [11][12][13][14][15][16][17][18][19][20][21][22]. The test developers (41) found a test-retest coefficient of 0.87 (P , 0.001), and for the full scale, the standardized-item alpha was 0.93 (P , 0.001).…”

Section: Methodsmentioning

confidence: 99%

“…Because secondary conditions are common in persons with disabilities (4)(5)(6)(7)(8), persons with severe SCI are more vulnerable to developing them (9,10) Anson and Shepherd (11) reported patterns of secondary complications among 348 outpatients evaluated by a clinical team. Approximately 95% had at least 1 secondary condition and 58% had 3 or more, with the most prevalent being pain (45%), overweight or obesity (40%), spasticity in patients with cervical or thoracic injuries (74%), urinary tract infections (27.2%), and pressure ulcers (22.4%).…”

Section: Introductionmentioning

confidence: 99%

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A Structural Analysis of Health Outcomes After Spinal Cord Injury

Krause

Reed

McArdle

2010

The Journal of Spinal Cord Medicine

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Objective: To develop and validate a latent model of health outcomes among persons with spinal cord injury. Methods: Survey data were collected at a large specialty hospital in the southeastern USA from 1,388 adult participants with traumatic spinal cord injury of at least 1 year's duration. Multiple indicators of health outcomes were used, including general health ratings, days adversely affected by poor health and poor mental health, treatments and hospitalizations, depressive symptoms, symptoms of illness or infection (eg, sweats, chills, fever), and multiple individual conditions (eg, pressure ulcers, subsequent injuries, fractures, contractures). Results: We performed exploratory factor analysis on half of the sample and confirmatory factor analysis on the other. A 6-factor solution was the best overall solution, because there was an excellent fit with the exploratory factor analysis (root mean square error of approximation 5 0.042) and acceptable fit with the confirmatory factor analysis (root mean square error of approximation 5 0.065). Four of the factors were types of secondary conditions, including symptoms of illness or infection, orthopedic conditions, pressure ulcers, and subsequent injuries. The 2 remaining factors reflected global health and treatment. Gender, race-ethnicity, age, injury severity, and years of education were all significantly related to at least 1 factor dimension, indicating variations in health outcomes related to these characteristics. Conclusion: Identification of the 6 factors represents an improvement over the utilization of multiple individual indicators, because composite scores generated from multiple individual indicators provide more informative and stable outcome scores than utilization of single indicators.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Structural Analysis of Health Outcomes After Spinal Cord Injury

Krause

Reed

McArdle

2010

The Journal of Spinal Cord Medicine

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“…Furthermore, although the brain injury in cerebral palsy is nonprogressive, the co-occurring impairments, diseases, and functional limitations change over time, reducing function and quality of life. 8 Definitive information about the real extent of cooccurring impairments, diseases, and functional limitations with cerebral palsy is essential for parents in choosing services and for providers in terms of pediatric resource allocation. 4 Moreover, the psychological and physical health of parents of children with cerebral palsy is strongly influenced by the child' s behavior and the complexity of caregiving demands.…”

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confidence: 99%

Clinical Prognostic Messages From a Systematic Review on Cerebral Palsy

et al. 2012

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OBJECTIVE: To summarize evidence on the rates of co-occurring impairments, diseases, and functional limitations with cerebral palsy into succinct clinical messages. METHODS:A search was conducted of the databases PubMed, Medline, CINAHL, and PsycINFO, and the results were supplemented with hand searches. Two independent reviewers determined whether retrieved abstracts met the following inclusion criteria: human subjects; .90% were children or adults with cerebral palsy; published after 1999; and population-based data. Articles were appraised, analyzing design, participants, level of evidence, rates of impairments, and functional implications. Methodologic quality was rated by using a standardized checklist. RESULTS:A total of 1366 papers were identified in the search; 82 were appraised and 30 were included in the meta-analyses. High-level evidence existed, as rated on the Oxford 2011 Levels of Evidence: 97% of prevalence studies were level 1. The data were of a moderate to high quality grade (with the exception of sleep disorders), allowing plain English clinical messages to be developed. CONCLUSIONS:Among children with cerebral palsy, 3 in 4 were in pain; 1 in 2 had an intellectual disability; 1 in 3 could not walk; 1 in 3 had a hip displacement; 1 in 4 could not talk; 1 in 4 had epilepsy; 1 in 4 had a behavior disorder; 1 in 4 had bladder control problems; 1 in 5 had a sleep disorder; 1 in 5 dribbled; 1 in 10 were blind; 1 in 15 were tube-fed; and 1 in 25 were deaf. Pediatrics 2012;130:e1285-e1312

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“…Relatively common musculoskeletal deformities include subluxations or dislocations of the hip, structural abnormalities of the foot/feet, patella alta, pelvic asymmetry/obliquity and contractures of various muscle groups (Gajdosik and Cicirello 2001 Osteoarthritis is also a common cause of pain for patients with CP and typically has an earlier onset in this population group when compared to the non CP population (Gajdosik and Cicirello 2001). It is thought that the altered joint loading patterns in childhood due to delayed weight bearing and altered muscle activity can lead to poor joint integrity and irreversible damage to the articular cartilage of the joint surface, consequently developing early onset OA, predominantly seen in the hip, knee and feet (Carter and Tse 2009).…”

Section: Common Musculoskeletal Disorders That Impact On Mobilitymentioning

confidence: 99%