Walking function, pain, and fatigue in adults with cerebral palsy: a 7‐year follow‐up study

Abstract

Aim To compare walking function, pain, and fatigue in adults with cerebral palsy (CP) 7 years after an initial survey. Method A multidimensional questionnaire was mailed to 226 people with unilateral (hemiplegic) or bilateral (diplegic) spastic CP who had participated in a 1999 survey. People with additional diagnoses were excluded. Special emphasis was placed on participants with deterioration in walking. The questionnaire was the same as in 1999. Results One hundred and forty‐nine participants (76 males, 73 females; mean age 40y 5mo, SD 10y 7mo, range 24–76y) with a diagnosis of unilateral (n=81) or bilateral (n=68) spastic CP responded. Fifty‐two per cent of all participants reported deterioration in walking function since debut of walking, compared with 39% 7 years previously. In participants with bilateral CP, 71% reported deteriorated walking, compared with 37% of participants with unilateral CP. Participants with deteriorated walking function had greater pain frequency, pain intensity, impact of pain on daily activities, and physical fatigue and reduced balance. The number of people reporting overall mobility problems was almost double compared with 7 years previously. Interpretation The main finding was an increased prevalence of deteriorated walking, significantly associated with bilateral spastic CP, pain, fatigue, and reduced balance. Rehabilitation programmes addressing these areas are needed.

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

“…For fatigue severity, similar levels were reported by Opheim et al, 7 which emphasizes the seriousness of fatigue in adults with SBCP. Three factors may affect fatigue in this population.…”

“…The present study showed similar levels of physical and mental fatigue in SBCP, whereas Jahnsen et al found higher levels of physical fatigue, but not mental fatigue, in those with CP than in the general population. 3,7 Third, pain medication, anti-spastic medication, and anti-depressants may have fatigue as a side effect.…”

Interventions to Improve or Maintain Lower-Limb Function Among Ambulatory Adolescents with Cerebral Palsy: A Cross-Sectional Survey of Current Practice in the UK

“…Around 25% of adults who can walk and climb stairs and 30% of adults who can walk but require a handrail for stairs at age 25 years will experience a decline in function over the following 15 years (Day et al, 2007). This prognosis is supported by the findings of Opheim et al (2009) who found that 52% of adults with CP aged 18 to 70 years experienced deterioration in their walking ability over a 7-year period. The provision of physiotherapy to people with CP in adolescence and young adulthood may play an important role in preventing this decline in function among young adults with CP.…”

Fatigue in cerebral palsy: A critical review

“…Indeed, a 7-year follow-up study reported that individuals whose walking ability deteriorated reported increased levels of physical fatigue, but no significant differences existed between a sample with CP and the general population in terms of mental fatigue. These results indicate that the fatigue experienced in CP is mainly of physiological origin [5], but the factors responsible are unclear. Thus, the purpose of this review is to synthesize information to explain the conflicting nature of fatigue in CP (with a specific focus on spastic CP), and to describe the characteristics of CP as it relates to fatigue during functional tasks of daily living [6].…”

“…Thus, in this context adults with CP experience higher levels of fatigue than the general population [4,5] and, with chronic pain it is estimated that this combination affects 34% of the population with CP [4]. Indeed, a 7-year follow-up study reported that individuals whose walking ability deteriorated reported increased levels of physical fatigue, but no significant differences existed between a sample with CP and the general population in terms of mental fatigue.…”