Skip to main content

Long-Term Prognosis

  • Chapter
  • First Online:
Cerebral Palsy
  • 3562 Accesses

Abstract

In children with cerebral palsy (CP) prognosis regarding unaided walking, need for walking aids or wheelchair is possible already at the age of 3 years. Gross motor function decreases in many adolescents and adults with CP due to pain, contractures, weight gain or burnout syndrome.

Chronic diseases and behavioural and emotional problems are more prevalent in adults with CP as compared to those without. Secondary musculoskeletal problems occur frequently. Especially pain becomes an important topic.

More than 90% of children with CP survive into adulthood. Life expectancy depends on GMFCS level and swallowing problems.

Transition from child- and family-centred services into those for adults remains a difficult topic, especially for severely handicapped individuals. Health and social services are used less often by adults with CP.

Health-related quality of life remains rather stable over the years; lower scores are found in severely affected persons. Participation strongly relates to the intellectual and social capacities of the individuals and may increase with improvements in rehabilitation technique, domestic assistance and legislation.

Happiness in life in individuals with CP is promoted by acceptance, trust placed in themselves by others and by means of confidence by themselves.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Bottos M, Feliciangeli A, Sciuto L, et al. Functional status of adults with cerebral palsy and implications for treatment of children. Dev Med Child Neurol. 2001;43:516–28.

    Article  CAS  PubMed  Google Scholar 

  2. Fedrizzi E, Facchin P, Marzaroli M, et al. Predictors of independent walking in children with spastic diplegia. J Child Neurol. 2000;15:228–34.

    Article  CAS  PubMed  Google Scholar 

  3. daPaz Junior AC, Burnett SM, Braga LW. Walking prognosis in cerebral palsy: a 22-year retrospective analysis. Dev Med Child Neurol. 1994;26:130–4.

    Google Scholar 

  4. Barnhart RC, Liemohn WP. Ambulatory status of children with cerebral palsy: a retrospective study. Percept Mot Skills. 1995;81:571–4.

    Article  CAS  PubMed  Google Scholar 

  5. Palisano RJ, Hanna SE, Rosenbaum P, Tieman B. Probability of walking, wheeled mobility, and assisted mobility in children and adolescents with cerebral palsy. Dev Med Child Neurol. 2010;52:66–71.

    Article  PubMed  Google Scholar 

  6. Holmefur M, Krumlinde-Sundholm L, Bergström J, Eliasson AC. Longitudinal development of hand function in children with unilateral cerebral palsy. Dev Med Child Neural. 2010;52:352–6.

    Article  Google Scholar 

  7. Fedrizzi E, Pagliano E, Andreucci E, Oleari G. Hand function in children with hemiplegic cerebral palsy: prospective follow-up and functional outcome in adolescence. Dev Med Child Neurol. 2003;45:85–91.

    Article  PubMed  Google Scholar 

  8. Andersson C, Mattsson E. Adults with cerebral palsy: a survey describing problems, needs, and resources, with special emphasis on locomotion. Dev Med Child Neurol. 2001;43:76–82.

    Article  CAS  PubMed  Google Scholar 

  9. Ando N, Ueda S. Functional deterioration in adults with cerebral palsy. Clin Rehabil. 2000;14:300–6.

    Article  CAS  PubMed  Google Scholar 

  10. Opheim A, Jahnsen R, Olsson E, Stanghelle JK. Walking function, pain, fatigue in adults with cerebral palsy: a 7-year follow-up study. Dev Med Child Neurol. 2009;51:381–8.

    Article  PubMed  Google Scholar 

  11. Andersson C, Grooten W, Hellsten M, et al. Adults with cerebral palsy: walking ability after progressive strength training. Dev Med Child Neurol. 2003;45:220–8.

    Article  CAS  PubMed  Google Scholar 

  12. Bates G, Willson SW. Clinical experience of constraint induced movement therapy in adolescents with hemiplegic cerebral palsy – a day camp model. Dev Med Child Neurol. 2003;45:357–60.

    Article  Google Scholar 

  13. Shortland A. Muscle deficits in cerebral palsy and early loss of mobility: can we learn something from our elders? Dev Med Child Neurol. 2009;51(Suppl):59–63.

    Article  PubMed  Google Scholar 

  14. Svehlik M, Steinwander G, Lehmann T, Kraus T. Predictors of outcome after single-event multilevel surgery in children with cerebral palsy: a retrospective ten-year follow-up study. Bone Joint J. 2016;98:278–81.

    Article  PubMed  Google Scholar 

  15. Tedroff K, Löwing K, Aström E. A prospective cohort study investigating gross motor function, pain, and health- related quality of life 17 years after selective dorsal rhizotomy in cerebral palsy. Dev Med Child Neurol. 2015;57:484–90.

    Article  PubMed  Google Scholar 

  16. Peterson MD, Ryan JM, Hurvitz MD, Mahmoudi E. Chronic conditions in adults with cerebral palsy. JAMA. 2015;314:2302–5.

    Google Scholar 

  17. Blackman JA, Conaway MR. Adolescents with cerebral palsy: transitioning to adult health care services. Clin Pediatr (Phila). 2014;53:356–63.

    Article  Google Scholar 

  18. Tosi LL, Maher N, Moore DW, et al. Adults with cerebral palsy: a workshop to define challenges of treating and preventing secondary musculoskeletal and neuromuscular complications in this rapidly growing population. Dev Med Child Neurol. 2009;51(Suppl):2–11.

    Article  PubMed  Google Scholar 

  19. Koop SE. Scoliosis in cerebral palsy. Dev Med Child Neurol. 2009;51(Suppl):92–8.

    Article  PubMed  Google Scholar 

  20. Renshaw TS, Green NE, Griffin PP. Cerebral palsy: orthopaedic management. J Bone Joint Surg. 1995;77-A:1590–606.

    Article  Google Scholar 

  21. Mergler S, Evenhius HM, Boot AM, et al. Epidemiology of low bone mineral density and fractures in children with severe cerebral palsy: a systematic review. Dev Med Child Neurol. 2009;51:773–7.

    Article  PubMed  Google Scholar 

  22. Marciniak C, Gabet J, Lee J, et al. Osteoporosis in adults with cerebral palsy: feasibility of DXA screening and risk factors for low bone density. Osteopos Int. 2016;27:1477–84.

    Article  CAS  Google Scholar 

  23. Iwasaki T, Nonoda Y, Ishii M. Long-term outcomes of children and adolescents who had cerebral palsy with secondary osteoporosis. Curr Med Res Opin. 2012;28:737–47.

    Article  CAS  PubMed  Google Scholar 

  24. Hodgkinson I, Jindrich ML, Duhaut P. Hip pain in 234 non-ambulatory adolescents and young adults with cerebral palsy: a cross-sectional multicentre study. Dev Med Child Neurol. 2001;43:806–8.

    Article  CAS  PubMed  Google Scholar 

  25. Murphy KP. Cerebral palsy lifetime care – four musculoskeletal conditions. Dev Med Child Neurol. 2009;51(Suppl):30–7.

    Article  PubMed  Google Scholar 

  26. Turk MA. Health, mortality, and wellness issues in adults with cerebral palsy. Dev Med Child Neurol. 2009;51(Suppl):24–9.

    Article  PubMed  Google Scholar 

  27. Vogtle LK. Pain in adults with cerebral palsy: impact and solutions. Dev Med Child Neurol. 2009;51(Suppl):113–21.

    Article  PubMed  Google Scholar 

  28. Goldfarb RA, Pisansky A, Fleck J, et al. Neurogenic lower urinary tract dysfunction in adults with cerebral palsy: outcomes following a conservative approach. J Urol. 2016;195:1009–13.

    Article  PubMed  Google Scholar 

  29. Bode H. Sozioökonomische Aspekte. In: Heinen F, Bartens W (Hrsg). Das Kind und die Spastik. Bern: Hans Huber; 2001. p. 49–59.

    Google Scholar 

  30. Strauss D, Cable W, Shavelle R. Causes of excess mortality in cerebral palsy. Dev Med Child Neurol. 1999;41:580–5.

    Article  CAS  PubMed  Google Scholar 

  31. Poulos AE, Balandin S, Llewellyn G, Dew AH. Women with cerebral palsy and breast cancer screening by mammography. Arch Phys Med Rehab. 2006;87:304–7.

    Article  Google Scholar 

  32. Williams K, Alberman E. Survival in cerebral palsy: the role of severity and diagnostic labels. Dev Med Child Neurol. 1998;40:376–9.

    CAS  PubMed  Google Scholar 

  33. Blair E, Watson L, Badawi N, Stanley FJ. Life expectancy among people with cerebral palsy in Western Australia. Dev Med Child Neurol. 2001;43:508–15.

    Article  CAS  PubMed  Google Scholar 

  34. Strauss D, Shavelle R. Life expectancy of adults with cerebral palsy. Dev Med Child Neurol. 1998;40:369–75.

    CAS  PubMed  Google Scholar 

  35. Hemming K, Hutton JL, Pharao PO. Long-term survival for a cohort of adults with cerebral palsy. Dev Med Child Neurol. 2006;48:90–5.

    Article  PubMed  Google Scholar 

  36. Touyama M, Touyama J, Ochiai Y, et al. Long-term survival of children with cerebral palsy in Okinawa, Japan. Dev Med Child Neurol. 2013;55:459–63.

    Article  PubMed  Google Scholar 

  37. Burns F, Stewart R, Reddihough D, et al. The cerebral palsy transition clinic: administrative chore, clinical responsibility, or opportunity for audit and clinical research? J Child Orthop. 2014;8:203–13.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Stewart D. Transition to adult services for young people with disabilities: current evidence to guide future research. Dev Med Child Neurol. 2009; 51:(Suppl 4):169–73.

    Google Scholar 

  39. Bolger A, Vargus-Adams J, Mcmahon M. Transition of care in adolescents with cerebral palsy: a survey of current practices. PMR. 2017;9:258–64.

    Article  Google Scholar 

  40. Darrah J, Magil-Evans J, Adkins R. How well are we doing? Families of adolescents or young adults with cerebral palsy share their perceptions of service delivery. Disab Rehabil. 2002;10:542–9.

    Article  Google Scholar 

  41. Stevenson CJ, Pharoah POD, Stevenson R. Cerebral palsy – the transition from youth to adulthood. Dev Med Child Neurol. 1997;39:336–42.

    Article  CAS  PubMed  Google Scholar 

  42. Murphy KP, Molnar GE, Lankasky K. Employment and social issues in adults with cerebral palsy. Arch Phy Med Rehabil 2000;81:807–811

    Google Scholar 

  43. Raina O, O’ Dovell M, Rosenbaum P, et al. The health and well-being of caregivers of children with cerebral palsy. Pediatrics. 2005;115:e626–36.

    Article  PubMed  Google Scholar 

  44. Centers for Disease Control and Prevention CDC. Economic costs associated with mental retardation, cerebral palsy, hearing loss, and visual impairment – United States. MMWR Morb Mort Wkly Rep. 2004;53:57–9.

    Google Scholar 

  45. Dickinson HO, Parkinson KN, Ravens-Sieberer U, et al. Self-reported quality of life of 8 –12 year old children with cerebral palsy: a cross-sectional European study. Lancet. 2007;36:2171–8.

    Article  Google Scholar 

  46. Nadeau L, Tessier R. Social adjustment of children with cerebral palsy in mainstream classes: peer perception. Dev Med Child Neurol. 2006;48:331–6.

    Article  PubMed  Google Scholar 

  47. Young NL, Rochon TG, McCormick A, et al. The health and quality of life outcomes among youth and young adults with cerebral palsy. Arch Phys Med Rehab. 2010;91:143–8.

    Article  Google Scholar 

  48. Orlin MN, Palisano RJ, Chiarell LA, et al. Participation in home, extracurricular, and community activities among children and young people with cerebral palsy. Dev Med Child Neurol. 2010;52:160–6.

    Article  PubMed  Google Scholar 

  49. Tan SS, Wiegerink DJ, Vos RC, et al. Developmental trajectories of socialparticipation in individuals with cerebral palsy: a multicenter longitudinal study. Dev Med Child Neurol. 2014;56:370–7.

    Article  PubMed  Google Scholar 

  50. Vos RC, Becher JG, Ketelaar M, et al. (2013) developmental trajectories of dailly activities in children and adolescents with cerebral palsy. Pediatrics. 2013;132:e915–23.

    Article  PubMed  Google Scholar 

  51. Nieuwenhuisen C, Dokervoort M, Niuwenstraten W, et al. Experienced problems of young adults with cerebral palsy: targets for rehabilitation care. Arch Phys Med Rehabil. 2009;90:1891–7.

    Article  Google Scholar 

  52. Alriksson-Schmidt A, Hägglund G, Rodby-Bousquet E, Westblom L. Follow-up of individuals with cerebral palsy through the transition years and description of adult life: the Swedish experience. J Pediatr Rehabil Med. 2014;7:53–61.

    PubMed  Google Scholar 

  53. Dussen van der L, Nieuwstraten W, Roebroeck M, et al. Functional level of young adults with cerebral palsy. Clin Rehabil. 2001;15:84–91.

    Article  Google Scholar 

  54. Michelsen SI, Uldall P, Kejs AM, Madsen M. Education and employment prospects in cerebral palsy. Dev Med Child Neurol. 2005;47:511–7.

    Article  PubMed  Google Scholar 

  55. Michelsen SI, Uldall P, Hansen T, Madsen M. Social integration of adults with cerebral palsy. Dev Med Child Neurol. 2006;48:643–9.

    Article  PubMed  Google Scholar 

  56. Tobimatsu Y, Nakamura R. Retrospective study of factors affecting employability of individuals with cerebral palsy in Japan. Tohoku J Exper Med. 2000;192:291–9.

    Article  CAS  Google Scholar 

  57. Wilson DJ, Mitchell JM, Kemp BJ, et al. Effects of assistive technology on functional decline in people aging with disability. Assist Technol. 2009;21:208–17.

    Article  PubMed  Google Scholar 

  58. King GA, Cathers T, Polgar JM. Success in life for older adolescents with cerebral palsy. Quality in Health Research. 2000;10:734–49.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Harald Bode .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Bode, H. (2018). Long-Term Prognosis. In: Panteliadis, C. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-67858-0_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-67858-0_32

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67857-3

  • Online ISBN: 978-3-319-67858-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics