Secondary Conditions of the Musculoskeletal System in Adolescents and Adults with Cerebral Palsy

Abstract

Cerebral palsy (CP) is a disability that affects individuals throughout their lifespan. Adolescents and adults with CP are at risk for many secondary conditions that cause a loss of function and deterioration of quality of life. This article presents a review of the literature of musculoskeletal conditions of people with CP that can develop or worsen across the lifespan as a consequence of the primary neuromotor impairments. Health care behaviors of adolescents and adults with CP are discussed and their impact on secondary conditions is examined. Suggestions for how pediatric occupational therapists and physical therapists can assist children and adolescents to take responsibility for their own health and wellbeing are presented. Lastly, occupational therapists and physical therapists are encouraged to take responsibility for treating musculoskeletal impairments and disabilities in adults with CP.

A longitudinal assessment of adherence to breast and cervical cancer screening recommendations among women with and without intellectual disability

“…Although it is unknown how effective these recommendations are for women with ID it has been documented that communication between obstetric and gynecologic providers and women with ID is problematic (Phillips et al, 2004; Dovey and Webb, 2000), and therefore, education of physicians about effective communication with women who have ID may have the potential to reduce disparities. Full adherence rates for Pap testing may also be impacted by previous difficulties due to anxiety or coexisting physical impairments (Tyler et al, 2010; Gajdosik and Cicirello, 2002; Krigger, 2006; Rapp and Torres, 2000). These concerns may be magnified in the context of doubts among physicians about the need for Pap testing due to low rates of cytologic abnormalities in women with ID (Quint and Elkins, 1997; Jaffe et al, 2002; Parish, 2013).…”

Effects of a recreational ice skating program on the functional mobility of a child with cerebral palsy

“…However, evidence for children in GMFCS level III supports a prognosis for steadily declining mobility through walking and increasing participation restriction as she approached puberty (Connolly, 2001;Donkervoort et al, 2007;Gajdosik and Cicirello, 2001;Johnson, Damiano, and Abel, 1997). She was also at risk for range of motion limitations in the lower extremities, multiple boney deformities due to abnormal muscle pull and gait deviations, and potential decreased cardiovascular fitness due to activity and participation restrictions (Connolly, 2001;Donkervoort et al, 2007;Gajdosik and Cicirello, 2001;Johnson, Damiano, and Abel, 1997). Her prognosis for improved function was fair due to support from extremely involved and educated parents who constantly sought out new opportunities for growth, and insisted she participate in family activities.…”

“…Other research cites a lack of postural control and stability from which coordinated movement of the extremities occurs (van der Heide and Hadders-Algra, 2005; Zadnikar and Kastrin, 2011). Even though the central nervous system damage of CP does not progress as the child ages, the activity limitations often continue to worsen as the child reaches adolescence and adulthood (Connolly, 2001;Donkervoort et al, 2007;Gajdosik and Cicirello, 2001;Johnson, Damiano, and Abel, 1997). Many of these limitations are due to the child's inability to develop the adequate muscle strength and endurance to functionally support their body as they grow and gain weight (Damiano, Dodd, and Taylor, 2002;Donkervoort et al, 2007;Johnson, Damiano, and Abel, 1997;Pruitt and Tsai, 2009).…”

Changes of Musculoskeletal Deformity in Severely Disabled Children Using the Custom Molded Fitting Chair

“…The rapid growth in adolescents is likely to cause musculoskeletal deformity and several other complications in adulthood [6]. The most common problem is deformities of the spine and hip joint in patients with CP [1].…”