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

Transition into adulthood of young adults with cerebral palsy: limitations in achieving independent life

M E ROEBROECK PHD A, M DONKERVOORT PHD A, D J H G
WIEGERINK MSC A,B, J VAN MEETEREN MD PHD A, H J STAM MD PHD
FRCP A, ON BEHALF OF THE TRANSITION RESEARCH GROUP SOUTH
WEST NETHERLANDS C

  1. 1. Department Rehabilitation Medicine, Erasmus MC- University Medical Center, Rotterdam;
  2. 2. Rijndam Rehabilitation Center, Rotterdam;
  3. 3. South West Netherlands Rehabilitation Centers, the Netherlands

Objectives: To investigate the transition process into adulthood of young adults with cerebral palsy (CP) for several domains of participation, and to assess which factors are related to the transition process.

Design: Analysis of 2-year follow-up and baseline data of a prospective cohort study.

Setting: Rehabilitation centers in the region.

Participants: Eighty-one young adults with CP aged 18 to 22 years without severe learning disabilities, from a cohort of 103 persons (baseline). The study cohort was recruited from an eligible total of 184 persons. Non-response, dropout (n=16), and missing data (n=6) were unbiased regarding sex, age, type of CP, and limb distribution of paresis. This study was part of the Pediatric Rehabilitation Research in the Nehterlands project.

Method: Participant characteristics and diagnosis –realted characteristics wer: age,sex, socioeconomic status, Gross Motor Function Classification System, and Manual Ability Classification System levels, and level of education. Functioning in daily activities and social participation was assessed with the Life Habits questionnaire. Using the Rotterdam Transistion Profile, we classified participants for each domain of participation into a phase of transition:

phase 1: dependency on others;
phase 2: increasing independence; and
phase 3: independent lifestyle. Partial correlations (Pearson’s r) were determined, controlling for age.

Results: Participants aged 18 to 22 years progressed in the transition process towards phase 2 or 3 on most domains of participation, except for housing and intimate relationships. Compared with peers, young adults with CP lag behind in independent housing (25% vs 36%), intimate relationships (37% vs 76%), and employment (23% vs 49%). After controlling for age, the phase of transition concerning transportation, leisure activities, and finances were related to diagnosis-related characteristics (r=0.30-0.48) and to limitations in these domains of activities and participation (r=0.43-0.48).

Conclusions: Young adults with CP show a delayed development in housing, intimate relationships, and employment. Delays in the transition process are associated with diagnosis-related characteristics and limitations in activities and participation.

Acknowledgements: The financial support of the Netherlands Organization for Health Research and Development and the Rotterdam Children’s Fund Adriaanstichting.

 
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