Employment and social issues in adults with cerebral palsy

Murphy, Kevin P.; Molnár, G; Lankasky, Kathleen

doi:10.1016/s0003-9993(00)90115-1

Cited by 102 publications

(61 citation statements)

References 7 publications

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“…A large percentage of individuals who were once mobile eventually stop ambulating, due to fatigue, inefficiency of gait, and/or muscle and joint pain. 4 The current findings demonstrated that level of mobility impairment was strongly associated with chronic conditions. This study was limited by the inability to determine cause-effect relationships between CP and chronic conditions; reliance on self-report data from a household member; Note: Variable-specific nonresponse rates generally ranged from 0-3%.…”

Section: Discussionsupporting

confidence: 51%

Prevalence of chronic diseases in a population‐representative sample of individuals with cerebral palsy

2015

Develop Med Child Neuro

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IntroductionAdults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP; 2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP. MethodsWe used the Full Year Consolidated and Medical Conditions files for 9 years of the Medical Expenditure Panel Survey (MEPS) (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) vs. 17.4%) (all: p<0.001). Adjusted odds ratios were significantly different for all conditions except diabetes and ranged from 1.32 (95% CI, 1.04-1.67) for hypertension to 2.03 (95% CI, 1.39-2.97) for emphysema. Age, sex, weight, physical disability, overall health and physical activity were also associated with chronic conditions (Table 2). DiscussionIn this population-based sample, adults with CP had significantly higher odds of chronic diseases compared with adults without CP-raising important questions about preventable health complications in this population.Accelerated functional losses are a concern in the aging CP population. A large percentage of individuals who were once mobile eventually stop ambulating, due to fatigue, inefficiency of gait, and/or muscle and joint pain. 4 The current findings demonstrated that level of mobility impairment was strongly associated with chronic conditions. This study was limited by the inability to determine cause-effect relationships between CP and chronic conditions; reliance on self-report data from a household member; and a borderline acceptable (60%) response rate. The sample of adults with CP may not be entirely representative of the total population of adults with CP. Approximately half of adults with CP reported having a minor or no disability, suggesting that the group was particularly high functioning. Future efforts are needed to better understand the healthcare utilization associated with chronic conditions for persons with CP and to characterize the relationship between mobility impairments, sedentary lifestyles and chronic conditions. Acknowledgement:

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Section: Discussionsupporting

confidence: 51%

Prevalence of chronic diseases in a population‐representative sample of individuals with cerebral palsy

2015

Develop Med Child Neuro

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“…Murphy et al (2000) included 101 specially selected individuals with CP in the US: 53% were competitively employed. O'Grady et al (1995) included a self-selected cohort of participants by reviewing records from a CP clinic in the United States: 49% were working, with 38% of those full time.…”

mentioning

confidence: 99%

Education and employment prospects in cerebral palsy

Michelsen

Uldall

Kejs

et al. 2007

Developmental Medicine &Amp; Child Neurology

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Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819 participants with CP born between 1965 and 1978 (471 males; mean age 28y 10mo, SD 4y, range 21 to 35y) in the Danish Cerebral Palsy Registry were compared with 4406 controls without CP born between 1965 and 1978 (2546 males; mean age 28y 10mo, SD 4y, range 21 to 35y). Diagnostic subtypes of the 819 participants with CP were: 31% hemiplegia, 43% diplegia, 18% tetraplegia, and 8% other types. Level of motor impairment with respect to walking ability was: 62% able to walk without assistance, 21% with assistance, and 16% not able to walk (for 1% of study children walking ability was not known). Relevant information was obtained from Denmark's unique registries. Of the participants with CP, 33% vs 77% of controls, had education beyond lower secondary school (i.e. after age 15-16y), 29% were competitively employed (vs 82% of controls), 5% were studying, and 5% had specially created jobs. Excluding participants with CP with an estimated developmental quotient (DQ) of less than 50 or inability to walk at age 5 to 6 years, the odds ratios (multivariate analysis) for not being competitively employed were 1.9 for diplegia versus hemiplegia, 22.5 for DQ 50 to 85 versus DQ greater than 85, and 3.7 for those with epilepsy versus those without epilepsy. The severity of motor impairment among participants with CP able to walk had just a minor influence. Only half the participants with CP who had attended mainstream schooling were employed. In conclusion several childhood characteristics seemed to predict long-term social prognosis.

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“…Tilt and recline functions are also indicated in this Group who are susceptible to hip and other joint contractures 30 and require pain and pressure relief 13;29;30 . EPIOCs provided for these children and those starting work are reported to facilitate greater functional mobility and to conserve energy for the physical demands of the workplace or college 31 . This has implications for payers or service commissioners as more chair functions will increase costs, in addition to the chair replacement costs consequent to user growth.…”

Section: Equipmentmentioning

confidence: 99%

Recipients of Electric-Powered Indoor/Outdoor Wheelchairs Provided by a National Health Service: A Cross-Sectional Study

Frank¹,

Souza²

2013

Archives of Physical Medicine and Rehabilitation

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Initially presented as an abstract to the 4 th International Interdisciplinary Conference on Posture and Mobility, June 7-9 2010, Glasgow, UK.We did not receive any funding for this study Acknowledgements: Mike Pugh for technical assistance with identifying those with tilt-inspace wheelchairs and commenting on engineering aspects of this paper.We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated and we certify that all financial and material support for this research and work are clearly identified in the title page. The benefits of powered mobility (PM) for people with severe disabilities are now better understood. By using powered wheelchairs, individuals can experience greater participation in activities such as education 1-4 or work [1][2][3]5 , and a range of social activities such as shopping 1-3;6;7;7;8 , church going 1;2;6;9 , socialising with family and friends 1;2;6;9;10 and accessing healthcare facilities 2;6;9;11. In addition, the increased mobility provided by PM enhances quality of life and wellbeing 5;10;12 . Benefits to carers have also been reported 2;5;9;11 . However, it has been noted that there are problems associated with powered mobility (PM There is a need to capture data from greater numbers representative of the population of wheelchair users 17 . Whilst such populations have been described 18 , the diagnoses, age and gender of a large and specific population of powered wheelchair users is lacking. Objectively verified data are needed for these factors as declarative data gathered through self-report Potential users were referred from locally based NHS wheelchair services. Clinic records including assessment and wheelchair equipment of those provided with an EPIOC, and still using it, were reviewed in June 2007 and data were extracted. Average time from the initial assessment in clinic to the case note review was 72.4 (range 0-1166, sd 73.2) months.The data relevant to this study had been recorded by health professionals following a physical examination and assessment and consisted of:- Demographic data• age at initial assessment• gender Medical factors• Major diagnosis contributing to the need for a wheelchair as described previously 2 but with the addition of a category for inherited metabolic conditions.• Ventilator issues• Problematic pain -that needed intervention(s).• (Kypho)scoliosis Users with multiple sclerosis (MS), cerebral palsy (CP), muscular dystrophy (MD), cerebrovascular disease (CVD), other neurological conditions, spina bifida (SB), spinal cord injury (SCI) and polio were grouped together as having neurological or neuromuscular conditions (NNCs). Wheelchair factorsPowered wheelchair provision in the UK 8• Specialised seating (SS) -that which is needed by people who require a wheelchair but due to instability or deformity need additional support in order to function 21 , (similar to that of adaptive seating 22 )• Tilt-in-space (TIS)• ...

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Employment and social issues in adults with cerebral palsy

Cited by 102 publications

References 7 publications

Prevalence of chronic diseases in a population‐representative sample of individuals with cerebral palsy

Prevalence of chronic diseases in a population‐representative sample of individuals with cerebral palsy

Education and employment prospects in cerebral palsy

Recipients of Electric-Powered Indoor/Outdoor Wheelchairs Provided by a National Health Service: A Cross-Sectional Study

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