Influence of gait analysis on decision-marketing for lower extremity surgery

Participation  in society among adults with cerebral palsy

C MINTER MA, C TYKOWSKI MD, K BYLICA-PERRYMAN MS, D KNAPP MSW

  1. 1. Shriners Hospitals for Children, Lexington, KY, USA

Objectives: To describe the  level at which adults with cerebral palsy (CP), who were treated at our hospital as children, participate in society.

Design: Prospective exploratory cohort study.

Participants: A convenience sample of 90 participants from a total of 610 (age 21-39y) with CP, and previously treated at our hospital, completed a telephone interview.

Method: Participants provided answers regarding demographic, medical, and community participation information. Gross Motor Function Classification System (GMFCS) level was measured and statistical comparisons were made using analyses of variance, with significance set at p<0.05.

Results: Mean age at interview was 24y 5mo (SD 2y 2mo) for 40 females and 50 males. Fifty-three percent lived in communities larger than 50,000; 93% were single, 34% were sexually active, and 11% were living independently of a caregiver. Forty-five percent were in GMFCS Level I or II, 32% were Level III,and 23% were Level IV or V. Eighty-three percent had completed high school or higher; 29% were currently employed. Sevent percent earned more than US$25,000 annually; 46% were on supplemental security income (SSI). Forty-one percent were driving and 39% were regularly excersing; more of their time was spent watching television (17h/wk) than any other activity, followed by internet (9h) and socializing (5h). Ninety-one percent described their health as `good’ or `excellent’. Ninety-two percent reported having health insurance and 51% had private insurance. Ten percent reported having chronic pain. Less than 10% reported problems with speech, chewing or swallowing, seizures, or pneumonia.Twenty-four percent reported having problems with drooling. Twelve percent were mobile in a wheelchair only. Within the past year, 74% had seen a primary care physician , 46% had seen a dentist, and 70% of females had seen a gynecologist. Those at GMFCS Level IV or V were significantly worse (p<0.05) for measures of mobility, sexual activity, living independently, income, employment, driving, education, SSI, health insurance, self-rated `excellent’ health, chronic pain, speech, chewing or swallowing, and drooling problems.

Conclusions: Adults with CP have relatively high levels of education, are mobile, in `good’ or `excellent’ health, able to seek necessary medical help, and have health insurance, with the majority coming from a private source. Despite this, they rely heavily on assistance from a caregiver and are poor participants in society as measured by income, employment, and marital status. As expected, ability to participate is negatively affected by worsening severity as measured by the GMFCS.

 
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