Walking through life with cerebral palsy: reflections on daily walking by adults with cerebral palsy

Abstract

Purpose: Walking is a major target in childhood physiotherapy for children with cerebral palsy (CP). Little information exists on the importance or value of walking when these children grow up. The aim of this study was to explore personal reflections on daily walking by adults with CP. Method: Semi-structured individual interviews were conducted and analysed with systematic text condensation, a four-step thematic cross-case analysis. Results: Eight ambulatory adults (26-60 years, four women and four men) with CP were interviewed. Almost all had experienced deteriorated walking ability in adulthood and reported that walking was restricted and affected by intrinsic features, such as pain, fatigue, reduced balance and fear of falling. Extrinsic features such as being looked at due to walking abnormality and environmental factors, such as seasonal changes affected their free walking and was common. Some had accepted using mobility aids for energy conservation. Conclusions: Both intrinsic and extrinsic factors influence walking in adults with CP. Reflections by the adults with CP suggest these features may reduce participation in public spaces and potentially increase acceptance and use of mobility aids.

A Life Course Perspective on Growing Older With Cerebral Palsy

“…Although the life course perspective provides a useful conceptual framework for research attending to the diversity and heterogeneity of life course trajectories, this strength may also be a challenge given the increasing complexity of societies and cultures around the world ( Hutchison, 2011 ). The findings of our study, which took place in the United States, are consistent with results from other Western countries ( Gjesdal et al, 2020 ; Horsman et al, 2010 ; King et al, 2000 ; Mudge et al, 2016 ; Palisano et al, 2020 ) suggesting that the life course perspective may have broader applicability. Future research is warranted using cross-cultural applications of this perspective to better understand how adults with CP are aging with a disability across the globe.…”

“… Palisano et al (2020) found that young adults with CP in Canada developed a process of actively adapting to different contexts over time to participate in activities perceived as important to their health and well-being. Similarly, research in Norway and Canada has shown that adults with CP are proactive in promoting their health and well-being by employing strategies to cope with the impact of age-related changes on their daily life ( Gjesdal et al, 2020 ; Horsman et al, 2010 ). Mudge et al (2016) found that one coping strategy used by their participants in New Zealand was taking charge of needing help as they aged.…”

Physical Activity Levels of Adolescents and Adults With Cerebral Palsy in Urban South Africa

“…The differences between the outcomes of the adolescents and adults with CP, particularly those who used assistive devices, compared to their peers may suggest that as individuals with CP grow into adulthood, they tend to be less physically active. This is in line with the decline in walking ability which was shown especially for those who are less independent in gait (42) and started as early as mid-30's in individuals with CP (43). Intrinsic (e.g., pain, fatigue) and extrinsic factors (e.g., environment) could be the cause of walking restrictions (44) and should try to be prevented.…”

Can adults with cerebral palsy perform and benefit from ballistic strength training to improve walking outcomes? A mixed methods feasibility study

“…Six participants reported improvement in walking (PGIC), but the results from the walk test (6MWT) and gross motor function (HiMAT) did not confirm this perceived improvement. In a qualitative study, both intrinsic and extrinsic factors have been shown to influence daily walking in adults with CP [ 43 ]. The comprehension of the exercise is necessary for walking function and balance makes the perception that the exercise works important.…”