Experienced Problems of Young Adults With Cerebral Palsy: Targets for Rehabilitation Care

Abstract 

Nieuwenhuijsen C, Donkervoort M, Nieuwstraten W, Stam HJ, Roebroeck ME; and the Transition Research Group South West Netherlands. Experienced problems of young adults with cerebral palsy: targets for rehabilitation care.

Objective

To determine the problems experienced by young adults with cerebral palsy (CP) and the relationship between those problems and personal and CP-related characteristics.

Design

Cross-sectional study.

Setting

Rehabilitation centers in the southwest Netherlands.

Participants

Young adults (N=87; aged 18–22y) with CP and normal intelligence (roughly corresponding to an intelligence quotient >70, excluding participants who attended schools for those with learning disabilities).

Interventions

Not applicable.

Main Outcome Measures

We used the Canadian Occupational Performance Measure in a semistructured interview to assess participants for experienced problems. We further categorized experienced problems according to the domains of the International Classification of Functioning, Disability and Health and assessed the relationship between those problems and personal and CP-related characteristics (eg, age, sex, level of gross motor functioning, manual ability, level of education) using appropriate correlation coefficients.

Results

Approximately 70% of participants experienced problems in daily life, addressing the areas of self-care (59%), productivity (52%), and leisure activities (37%). More specifically, problems were most prevalent in recreation and leisure (30%), preparing meals (29%), housework (14%), and dressing (14%). Problems in functional mobility, paid or unpaid work, and socialization were considered as most important (represented by the highest mean importance score). Mobility problems were associated with lower levels of gross motor functioning (Spearman ρ=.39), and problems with self-care were associated with lower levels of manual ability (Spearman ρ=.40).

Conclusions

Although frequently addressed during pediatric rehabilitation care, problems with mobility and self-care still prevail in young adults with CP. In addition, during the transition into adulthood, young adults with CP may experience problems regarding domestic life and work, which they consider important.

Key Words: Activities of daily living, Cerebral palsy, Health transition, Rehabilitation

List of Abbreviations: COPM, Canadian Occupational Performance Measure, CP, cerebral palsy, GMFCS, Gross Motor Functioning Classification System, ICF, International Classification of Functioning, Disability and Health, MACS, Manual Ability Classification System