Highlights
- •On average, adults with cerebral palsy (CP) are fatigued, and a majority experience pain.
- •A minority of adults with CP are employed and live independently.
- •Those without intellectual disability are often ambulant and live independently.
- •Epilepsy and asthma are common comorbidities in adults with CP.
Abstract
Objective
To describe the epidemiology of health status, impairments, activities and participation
in adults with cerebral palsy (CP).
Data Sources
Embase, MEDLINE, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied
Health, Cochrane, and Google Scholar were searched for 3 themes (“cerebral palsy,”
“adult,” and “outcome assessment”) in literature published between January 2000 and
December 2018.
Study Selection
Full-article peer-reviewed English journal articles on descriptive, observational,
or experimental studies describing the most studied outcomes in adults with CP (n≥25,
age≥18y) were included. Studies were included in the analyses if frequently studied
outcomes were described in at least 3 studies using similar methods of assessment.
Data Extraction
Data were extracted independently by 2 authors from 65 articles (total N=28,429) using
a standardized score sheet.
Data Synthesis
Meta-analyses revealed that overall, on average 65.1% (95% confidence interval [CI],
55.1-74.5) of adults with CP experienced pain, 57.9% (95% CI, 51.1-64.6) were ambulant,
65.5% (95% CI, 61.2-69.7) had little or no limitation in manual ability, 18.2% (95%
CI, 10.6-27.2) had tertiary education, 39.2% (95% CI, 31.5;47.1) were employed, and
29.3% (95% CI, 9.0-55.3) lived independently. In adults without intellectual disability,
proportions of individuals who were ambulant (72.6% [95% CI, 58.8-84.5]) and lived
independently (90.0% [95% CI, 83.8-94.9]) were higher (P=.014 and P<.01, respectively). The Fatigue Severity Scale score was 4.1 (95% CI, 3.8-4.4). Epilepsy
(28.8% [95% CI, 20.1-38.4]) and asthma (28.3% [95% CI, 18.7-38.9]) were especially
prevalent comorbidities.
Conclusions
The present systematic review and meta-analysis on the epidemiology of adults with
CP provided state-of-the-art knowledge on the most frequently studied outcomes. On
average, adults with CP are fatigued, and a majority experience pain, are ambulant,
and have little or no difficulty with manual ability. On average, 40% are employed
and 30% live independently. More uniformity in assessment and reports is advised to
improve knowledge on epidemiology and gain insight in more outcomes.
Keywords
List of abbreviations:
BMI (body mass index), CI (confidence interval), CP (cerebral palsy), FSS (Fatigue Severity Scale), GMFCS (Gross Motor Function Classification System), ICF (International Classification of Functioning, Disability and Health), ID (intellectual disability), MACS (Manual Ability Classification System), SF-36 (Short Form-36 Health Survey)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 11, 2020
Footnotes
Supported by Rijndam Rehabilitation, Rotterdam, The Netherlands.
Disclosures: none
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
