Abstract
Objectives
To determine the prevalence and type of bowel symptoms, and their impact on health-related
quality of life (HRQOL) in adults with cerebral palsy (CP).
Design
Prospective cross-sectional study.
Setting
Urban, outpatient rehabilitation facility.
Participants
Adults with CP (N=91; 46 men, 45 women; mean age, 36y; age range, 18–79y).
Intervention
Not applicable.
Main Outcome Measures
Participants were interviewed using standardized instruments to assess the frequency
and types of bowel dysfunction. The International Consultation of Incontinence Questionnaire–Bowel
was used to assess bowel incontinence and impact on quality of life, and constipation
presence was determined using the Rome III criteria for constipation. Constipation
symptoms were rated by the Patient Assessment of Constipation–Symptom Scale. Participants'
mobility status was classified using the Gross Motor Function Classification System
(GMFCS). Interactions between mobility measures, anthropometric measures, and bowel
symptoms were assessed.
Results
Of the 91 participants enrolled, 62.6% were GMFCS IV or V. Twenty-eight participants
(30.8%) reported severe difficulty with control of liquid stool (rating never or rarely);
these participants were more likely to have a greater GMFCS level (P=.0004). Twenty-six participants (28.6%) reported that bowel function caused embarrassment
some/most/all of the time. Fifty-nine participants (64.8%) met criteria for chronic
constipation, which did not differ by GMFCS levels. Overall, 57.1% of participants
reported that bowel symptoms interfered with life; 40.7% reported moderate to severe
interference.
Conclusions
Bowel symptoms were frequent, a source of embarrassment, and impacted HRQOL in these
adults with CP. Addressing bowel-related symptoms has the potential to improve HRQOL
in these adults.
Keywords
List of abbreviations:
BMI (body mass index), CP (cerebral palsy), GI (gastrointestinal), GMFCS (Gross Motor Function Classification System), HRQOL (health-related quality of life), ICIQ-B (International Consultation of Incontinence Questionnaire–Bowel), NHANES (National Health and Nutrition Examination Survey), PAC-SYM (Patient Assessment of Constipation–Symptom Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 21, 2015
Footnotes
Supported by internal funding of the Rehabilitation Institute of Chicago.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
