PurposeIndividuals with cerebral palsy (CP) are at increased risk for frailty and chronic disease due to factors experienced throughout the lifespan, such as excessive sedentary behaviors and malnutrition. However, little is known about noncommunicable diseases (NCDs) and multimorbidity profiles in young adults with CP. The study objective was to compare NCD and multimorbidity profiles between young adults with and without CP.MethodsA clinic-based sample of adults (18–30 years) with (n=452) and without (n=448) CP was examined at the University of Michigan Medical Center. The prevalence and predictors of 13 NCDs were evaluated, including existing diagnoses or historical record of musculoskeletal, cardiometabolic, and pulmonary morbidities. The level of motor impairment was determined by the Gross Motor Function Classification System (GMFCS) and stratified by less vs more severe motor impairment (GMFCS I–III vs IV–V). Logistic regression was used to determine the odds of NCD morbidity and multimorbidity in adults with CP compared to adults without CP, and for GMFCS IV–V compared to GMFCS I–III in those with CP, after adjusting for age, sex, body mass index, and smoking.ResultsAdults with CP had a higher prevalence of osteopenia, osteoporosis, hypertension, myocardial infarction, hyperlipidemia, asthma, and multimorbidity compared to adults without CP, and higher odds of musculoskeletal (odds ratio [OR]: 6.97) and cardiometabolic morbidity (OR: 1.98), and multimorbidity (OR: 2.67). Adults with CP with GMFCS levels IV–V had a higher prevalence of osteopenia/osteoporosis, osteoarthritis, hypertension, other cardiovascular conditions, pulmonary embolism, and multimorbidity, and higher odds of musculoskeletal (OR: 3.41), cardiometabolic (OR: 2.05), pulmonary morbidity (OR: 1.42), and multimorbidity (OR: 3.45) compared to GMFCS I–III.ConclusionYoung adults with CP have a higher prevalence of chronic NCDs and multimorbidity compared to young adults without CP, which is pronounced in those with more severe motor impairment. These findings reiterate the importance of early screening for prevention of NCDs in CP.

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Individuals with cerebral palsy (CP) have an increased risk for the early development of osteoporosis; however, little is known about the epidemiology of osteoporosis for adults with CP, which is vital to inform clinical practice for osteoporosis prevention, treatment, and management. The purpose of this cross‐sectional study was to determine sex‐stratified prevalence of osteoporosis among adults with CP, as compared with adults without CP. Data from 2016 were extracted from Optum Clinformatics Data Mart (private insurance administrative claims data) and a random 20% sample from the fee‐for‐service Medicare (public insurance administrative claims data). Diagnostic codes were used to identify CP and osteoporosis diagnoses. Sex‐stratified prevalence of osteoporosis was compared between adults with and without CP for the following age groups: 18 to 30, 31 to 40, 41 to 50, 51 to 60, 61 to 70, and >70 years of age. The overall prevalence of osteoporosis was 4.8% for adults without CP (n = 8.7 million), 8.4% for privately insured adults with CP (n = 7,348), and 14.3% for publicly insured adults with CP (n = 21,907). Women and men with CP had a higher prevalence of osteoporosis compared with women and men without CP for all age groups. Finally, publicly insured women and men with CP had a higher prevalence of osteoporosis compared with privately insured women and men with CP for all age groups, except for the similar prevalence among the 18‐ to 30‐year age group. These findings suggest that osteoporosis is more prevalent among adults with CP compared with adults without CP. Study findings highlight the need for earlier screening and preventive medical services for osteoporosis management among adults with CP. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research

The aim of this study was to compare the prevalence of osteoarthritis between adults with and without cerebral palsy. Data were collected from the 2016 Optum Clinformatics® Data Mart, a nationwide de-identified US insurance claims database, containing medical and pharmacy information on beneficiaries. International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (age 18+ years) with and without cerebral palsy. ICD-10 codes were also used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with (n = 7,348) and without (n = 8.7 million) cerebral palsy, before and after adjusting for age and sex. The results showed that adults with cerebral palsy had a higher prevalence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis. Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with men and women without cerebral palsy across all age groups. Adults with cerebral palsy had a higher prevalence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan. Objective: Adults with cerebral palsy have an increased risk of developing osteoarthritis. However, little is known about the epidemiology of osteoarthritis among this vulnerable population. The objectives of this study were to compare the prevalence of osteoarthritis between adults with and without cerebral palsy, and to determine how the prevalence of osteoarthritis changes throughout adulthood for each group. Design: Data were extracted from the 2016 Optum Clinformatics® Data Mart, a nationwide database of de-identified US insurance claims, containing medical and pharmacy information on beneficiaries. Subjects: International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (18+ years) with (n = 7,348) and without (n = 8.7 million) cerebral palsy. Methods: ICD-10 codes were used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with and without cerebral palsy before and after adjusting for age and sex. The prevalence of any type of osteoarthritis was compared between men and women with and without cerebral palsy, stratified by the following age groups: 18-30, 31-40, 41-50, 51-60, 61-70, and > 70 years. Results: Adults with cerebral palsy had higher prevalence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis (odds ratio (OR): 1.3-2.1; p < 0.001), but not hand osteoarthritis (OR: 0.86; p = 0.46). Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with adults without cerebral palsy across all age groups (all p < 0.05). Conclusion: Privately-insured adults with cerebral palsy had a higher prevalence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan.

Background Regenerative peripheral nerve interfaces (RPNIs) transduce neural signals to provide high‐fidelity control of neuroprosthetic devices. Traditionally, rat RPNIs are constructed with ~150 mg of free skeletal muscle grafts. It is unknown whether larger free muscle grafts allow RPNIs to transduce greater signal. Methods RPNIs were constructed by securing skeletal muscle grafts of various masses (150, 300, 600, or 1200 mg) to the divided peroneal nerve. In the control group, the peroneal nerve was transected without repair. Endpoint assessments were conducted 3 mo postoperatively. Results Compound muscle action potentials (CMAPs), maximum tetanic isometric force, and specific muscle force were significantly higher for both the 150 and 300 mg RPNI groups compared to the 600 and 1200 mg RPNIs. Larger RPNI muscle groups contained central areas lacking regenerated muscle fibers. Conclusions Electrical signaling and tissue viability are optimal in smaller as opposed to larger RPNI constructs in a rat model.