Cerebral Palsy Effects through Lifespan: Difference between revisions
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Joint pain is a common occurance, even in young adults; it occurs as a result of the abnormal strain on the joints. A large Norwegian study of adults with CP aged from 18 to 72 years old found that 82% reported musculo-skeletal pain from at least one part of the body. 28% of the CP cohort reported daily pain for a year or more, compared to just 15% in the non-CP population<ref name="Jahnsen et al">Jahnsen R, Villien L, Aamodt G, Stanghelle J, Holm I. Musculoskeletal pain in adults with cerebral palsy compared with the general population. Journal of Rehabilitation Medicine. 2004 Mar 1;36(2):78-84.</ref>. | Joint pain is a common occurance, even in young adults; it occurs as a result of the abnormal strain on the joints. A large Norwegian study of adults with CP aged from 18 to 72 years old found that 82% reported musculo-skeletal pain from at least one part of the body. 28% of the CP cohort reported daily pain for a year or more, compared to just 15% in the non-CP population<ref name="Jahnsen et al">Jahnsen R, Villien L, Aamodt G, Stanghelle J, Holm I. Musculoskeletal pain in adults with cerebral palsy compared with the general population. Journal of Rehabilitation Medicine. 2004 Mar 1;36(2):78-84.</ref>. | ||
The back, hip, lower limbs an shoulders are the most common pain locations in many studies. | The back, hip, lower limbs an shoulders are the most common pain locations in many studies<ref name="Hilberink" />. | ||
== <span style="font-size: 19.92px; line-height: 1.5em; background-color: initial;">Outcome Measures</span> == | == <span style="font-size: 19.92px; line-height: 1.5em; background-color: initial;">Outcome Measures</span> == | ||
Revision as of 00:02, 12 July 2016
Original Editor - Wendy Walker
Lead Editors Wendy Walker
Introduction[edit | edit source]
Cerebral Palsy [CP] is defined as "a disorder of movement and posture that appears during infancy or early childhood resulting from damage to the brain". The brain injury is permanent, although interventions, particularly physiotherapy, in infancy and childhood can improve the physical performance and function in individuals with CP.
Effects of CP in Adulthood[edit | edit source]
Life Expectancy[edit | edit source]
Individuals with very profound CP (ie. complete dependence for all activities of daily living) who have severe reduction in postural control may experience compression of internal organs due to soft tissue contractures and asymmetrical posture, eg. severe scoliosis, and in these cases life expectancy may be reduced[1].
However, the majority of individuals with CP will have a similar life expectancy to non-CP people.
The main factors for life expectancy in CP are gross motor function and feeding difficulties. Individuals who are independently ambulant and able to feed independently have life expectancies in the normal range[2].
Post-Impairment Syndrome[edit | edit source]
This syndrome occurs in adulthood and comprises a combination of several or all of the following:
increase in muscle weakness, fatigue, pain, bone deformities, over-use syndrome or repetitive strain injuries, degenerative arthritis.
Muskuloskeletal abnormalities which do not result in discomfort during childhood frequently start to cause pain in adulthood. Abnormal approximation of joint surfaces can lead to early development of osteoarthritis (degenerative arthritis). Limitation in muscle strength and alterations of movement patterns mean that people with CP are at risk of developing overuse syndromes.
Reduced Ambulation[edit | edit source]
Independent walking, both with and without use of walking aids, is known to reduce significantly in adulthood, with a number of individuals losing the ability to walk independently and an increase in the wheelchair use[3].
In one study of adults with CP[4], 44% reported deterioration in ambulation.
Fatigue[edit | edit source]
Studies have demonstrated that in adults (even young adults) with CP the prevalence of fatigue is much higher than in the general population. One study looking at bilateral CP reports fatigue in 61% of patients, with 40% complaining of severe fatigue[5]; another (from Norway) looked at both unilateral and bilateral CP and found that 30% experienced fatigue, compared to just 18% in the general population[6].
A recent study in the Netherlands explored which subgroups of CP are more at risk of fatigue[7]; the authors found that "participants with bilateral CP were more fatigued and should be considered at risk for higher levels of fatigue" and conclude "we recommend that rehabilitation programmes to decrease fatigue for young adults with CP should use a multifactorial approach".
Bladder Dysfunction[edit | edit source]
A variety of bladder problems can occur, including urine retention, hyperreflexia and urge incontinence[8].
Joint Deformities[edit | edit source]
The abnormal strain put on the joints of individuals with CP, and the fact that the bones have grown under this abnormal loading, frequently leads to joint deformities, mainly in the spine and lower limbs[9][10].
These include:
Patella alta
Hip displacement
Scoliosis
Cervical stenosis
Pain[edit | edit source]
Joint pain is a common occurance, even in young adults; it occurs as a result of the abnormal strain on the joints. A large Norwegian study of adults with CP aged from 18 to 72 years old found that 82% reported musculo-skeletal pain from at least one part of the body. 28% of the CP cohort reported daily pain for a year or more, compared to just 15% in the non-CP population[11].
The back, hip, lower limbs an shoulders are the most common pain locations in many studies[10].
Outcome Measures[edit | edit source]
Reduction in mobility/walking:
Management / Interventions
[edit | edit source]
add text here relating to management approaches to the condition
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
[edit | edit source]
add appropriate resources here
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Hutton JL, Pharoah POD (2006). Life expectancy in severe cerebral palsy. Archives of Disease in Childhood, 91:254-258
- ↑ Strauss DJ, Shavelle RM, Rosenbloom L, Brooks JC (2008). Life expectancy in cerebral palsy: An update. Developmental Medicine &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Child Neurology, 50:487-493
- ↑ Michele Bottos, Alessandra Feliciangeli, Lucia Sciuto, Christina Gericke and Andrea Vianello (2001). Functional status of adults with cerebral palsy and implications for treatment of children. Developmental Medicine &amp;amp;amp;amp;amp;amp;amp;amp;amp; Child Neurology, , pp 516-528. doi:10.1017/S0012162201000950.
- ↑ Jahnsen R, Villien L, Egeland T, Stanghelle JK. Locomotion skills in adults with cerebral palsy. Clinical rehabilitation. 2004 Mar 1;18(3):309-16.
- ↑ Van Der Slot WM, Nieuwenhuijsen C, Van Den Berg-Emons RJ, Bergen MP, Hilberink SR, Stam HJ, Roebroeck ME. Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy. Dev Med Child Neurol. 2012;54:836–842
- ↑ Van Der Slot WM, Nieuwenhuijsen C, Van Den Berg-Emons RJ, Bergen MP, Hilberink SR, Stam HJ, Roebroeck ME. Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy. Dev Med Child Neurol. 2012;54:836–842
- ↑ Russchen HA, Slaman J, Stam HJ, et al. Focus on fatigue amongst young adults with spastic cerebral palsy. Journal of NeuroEngineering and Rehabilitation. 2014;11:161. doi:10.1186/1743-0003-11-161.
- ↑ Mayo ME. Lower urinary tract dysfunction in cerebral palsy. The Journal of urology. 1992 Feb;147(2):419-20.
- ↑ Tosi LL, Maher N, Moore DW, Goldstein M, Aisen ML. Adults with cerebral palsy: a workshop to define the challenges of treating and preventing secondary musculoskeletal and neuromuscular complications in this rapidly growing population. Developmental Medicine &amp; Child Neurology. 2009 Oct 1;51(s4):2-11.
- ↑ 10.0 10.1 Hilberink SR, Roebroeck ME, Nieuwstraten W, Jalink L, Verheijden J, Stam HJ. Health issues in young adults with cerebral palsy: towards a life-span perspective. Journal of Rehabilitation Medicine. 2007 Oct 5;39(8):605-11.
- ↑ Jahnsen R, Villien L, Aamodt G, Stanghelle J, Holm I. Musculoskeletal pain in adults with cerebral palsy compared with the general population. Journal of Rehabilitation Medicine. 2004 Mar 1;36(2):78-84.
