The epidemiology of cerebral palsy in adulthood: A systematic review and meta-analysis of the most frequently studied outcomes

Publication date: Available online 12 February 2020

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Marloes van Gorp, Sander R. Hilberink, Suzie Noten, Joyce L. Benner, Henk J. Stam, Wilma MA. van der Slot, Marij E. Roebroeck

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, CINAHL, Cochrane and Google Scholar were searched for three themes (‘cerebral palsy’, ‘adult’, and ‘outcome assessment’) in literature published between January 2000 and December 2018.

Study selection

Full paper, peer-reviewed, English journal articles on descriptive, observational or experimental studies describing the most studied outcomes in adults with CP (n ≥ 25, age ≥ 18 years) 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 two authors from 65 articles (total n=28429) using a standardized score sheet.

Data synthesis

Meta analyses revealed that overall, on average 65.1% (95% CI: 55.1;74.5) of adults with CP experienced pain, 57.9% (51.1;64.6) were ambulant, 65.5% (61.2;69.7) had little or no limitation in manual ability, 18.2% (10.6;27.2) had tertiary education, 39.2% (31.5;47.1) were employed and 29.3% (9.0;55.3) lived independently. Considering adults without intellectual disability, proportions of individuals who were ambulant (72.6% [58.8;84.5]) and lived independently (90.0% [83.8;94.9]) were higher (respectively p=0.014 and p<0.01). The Fatigue Severity Scale score was 4.1 (3.8;4.4). Epilepsy (28.8% [20.1;38.4]) and asthma (28.3% [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 the average adults with CP are fatigued, a majority experiences pain, is ambulant and has little or no difficulty with manual ability. On average, 40% is employed and 30% lives independently. More uniformity in assessment and reports is advised to improve knowledge on epidemiology and gain insight in more outcomes.

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