Aim To investigate the prevalence of metabolic syndrome and cardiovascular disease (CVD) risk factors and the association between common metabolic markers and Gross Motor Function Classification System (GMFCS) levels in ambulatory adults with cerebral palsy (CP). Method Metabolic markers and GMFCS levels were evaluated in a cross‐sectional study of 70 ambulatory adults with CP (34 males, 36 females; mean age 24y 5mo [SD 5y 4mo], range 18y 6mo–48y 8mo) to determine the prevalence of metabolic syndrome and CVD risk factors, and were compared to age‐matched, population norms from the National Health and Nutrition Examination Survey (NHANES) registry. The Framingham Heart Study (FHS) CVD risk estimation was also used to evaluate an individual's risk for CVD. Results Metabolic syndrome was identified in 17.1% of the cohort, higher than the 10% in the NHANES registry. The FHS CVD 30‐year lipid and body mass index (BMI)‐based risk factor results showed that 20% to 40% of the cohort was at greater risk of developing CVD (BMI‐based: 39.7% ‘full’ CVD risk factor; lipid‐based: 26.5% ‘full’ CVD risk factor) as compared to the FHS normative population data. There was a positive correlation between GMFCS level, waist circumference (r=0.28, p=0.02), and waist‐to‐hip ratio (r=0.28, p=0.02). Interpretation Adults with CP are at higher risk of CVD and metabolic syndrome compared to the general population, which is probably because of impaired mobility. What this paper adds Gross Motor Function Classification System levels can predict cardiovascular disease (CVD) risk factors in adults with cerebral palsy (CP). Anthropometric measures are significant in predicting CVD risk factors in adults with CP. Early CVD screening and ongoing risk factor monitoring are important in adults with CP.

Pediatric spina bifida (SB) and spinal cord injury (SCI) are unfortunately common in our society, and their unique findings and comorbidities warrant special consideration. This manuscript will discuss the epidemiology, pathophysiology, prevention, and management strategies for children growing and developing with these unique neuromuscular disorders. Growth and development of the maturing child places them at high risk of spinal cord tethering, syringomyelia, ascending paralysis, pressure injuries, and orthopedic abnormalities that must be addressed frequently and judiciously. Similarly, proper neurogenic bladder and neurogenic bowel management is essential not just for medical safety, but also for optimal psychosocial integration into the child’s expanding social circle.

PURPOSE: To understand the relationship of walking speed to self-reported pain, fatigue, and physical function in adults with CP. METHODS: Design: Cross-sectional study. Setting: Accredited clinical motion analysis laboratory in a regional children's hospital. Participants: 72 ambulatory patients 18 years of age, diagnosed with CP, who previously had 1 prior instrumented gait analysis at our facility. Main Outcome Measures: PROMIS-57 pain interference/intensity, physical function, and fatigue measures and walking speed. RESULTS: Physical function was significantly lower than able-bodied normal values by 1-2 standard deviations (40.3 ± 8.5). Pain interference (51.4 ± 9.0) and fatigue (50.2 ± 9.2) were not significantly different when compared to able-bodied normal values. Only physical function was statistically correlated with walking speed (p < 0.001), while pain interference (p = 0.39), pain intensity (p = 0.36), and fatigue (p = 0.75) were not. Pain interference, pain intensity, and fatigue were not statistically significant factors in the multiple regression of walking speed. Fatigue could significantly predict physical function, pain interference, and pain scores (p = 0.032, p < 0.001, p < 0.01, respectively), however, fatigue did not directly predict walking speed (p = 0.747). CONCLUSIONS: Self-reported physical function correlates with objectively measured walking speed in young adults with CP while patient-reported pain and fatigue did not, contrary to what would be predicted by the literature.