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The investigators aimed to understand the unmet needs of adults with cerebral palsy (CP) living in urban South Africa and to ascertain similarities or differences to typically developing (TD) adults in the same community. Participants were interviewed with an adapted version of the Southampton Needs Assessment Questionnaire (SNAQ). Non-parametric statistical analysis was utilised for quantitative data and qualitative data were analysed using free coding to identify themes. Thirty adults with CP (median age 34.8 years; GMFCS levels I/II/III/IV/V: n = 6/6/5/7/6; socio-economic status (SES) low/average/high: n = 8/17/5) were matched for gender, age, and SES. Adults with CP reported a higher unemployment rate and lower level of satisfaction with access to health services than TD peers. Core themes identified by the participants with CP that made community participation more difficult were physical capacity, poor access to accommodation, transport and health services, lack of socialising opportunities, poor universal design, and lack of financial independence. Adults with CP reported experiencing many challenges in their communities. Improved access to health care services and transport, and the universal design of housing and community buildings to accommodate individuals with a disability should be made a priority. Adults with cerebral palsy (CP) reported that their disability had an impact on their social life, home life, and work life. Accessibility issues have been identified as a major factor affecting adults with CP in a variety of areas, including access to and use of health services, housing, transportation, and community buildings. Adults with CP reported the need for support during the transition to adulthood, especially with developing life skills that will promote living independently in the community as adults with disabilities. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the prevalence and level of disability due to pain, health-related quality of life (HRQoL) and mental health in adolescents and adults with cerebral palsy (CP), living in a low-to-middle income country (LMIC), compared to matched typically developing (TD) peers, and to explore associations with individual characteristics. This case-control study included 31 adolescents and 30 adults with CP (gross motor function classification system [GMFCS] Level I–V) and matched TD peers. Assessment tools used were a pain questionnaire, the Oswestry Disability Index (ODI), Short-Form Health Survey (SF-36v2), Hospital Anxiety and Depression Scale (HADS), and General Self Efficacy (GSE) scale. Both CP cohorts reported more frequent pain in their lower limbs, higher level of disability due to pain (total ODI score) and lower perceived physical HRQoL compared to TD peers, while their mental health (mental HRQoL, HADS, and GSE) was not different. Despite the physical challenges faced by adolescents and adults with CP living in urban South Africa, the mental health scores showed no difference compared to TD peers. Care should be taken to maintain this positive mental state during ageing across their lifespan. The prognosis of individuals with cerebral palsy (CP) has improved over the last three decades and CP should therefore be considered as a lifelong condition. Adolescents and adults with CP living in urban South Africa reported a higher level of disability due to pain and lower physical health-related quality of life compared to typically developing peers, while their level of depression, anxiety, and self-esteem was not different. These results were similar to findings of studies conducted in high-income countries, though it cannot be generalised to other low to middle-income countries with different cultural and government systems. In order to promote healthy ageing across their lifespan, intervention programmes should be considered to improve physical well-being, and care should be taken to maintain their positive mental health. [ABSTRACT FROM AUTHOR]

To determine changes in level of accomplishment and satisfaction in daily activities and social participation, and functional mobility in adults with cerebral palsy (CP) more than 25 years after selective dorsal rhizotomy (SDR). This long-term observational nine-year follow-up study included 26 adults (median age 35 years) with CP and spastic diplegia, and 26 matched typically developing adults. Assessment tools used were the Life-Habits questionnaire and the Functional Mobility Scale. Most of the adults with CP were independent and satisfied with accomplishing life habits and no changes were determined, except for a small change in the Housing accomplishment level. Compared to typically developing adults, the CP cohort was more dependent in accomplishing Mobility and Recreation. However, the level of satisfaction was similar for most life habits except for Mobility. Functional mobility did not change, but correlated with Life-Habits results. Adults with CP showed high and stable levels of accomplishment and satisfaction in daily activities and social participation more than 25 years after SDR. This is in contrast with the literature, where functional decline was shown for individuals with CP as they age. The relation with functional mobility highlights the importance to focus the rehabilitation on maintaining walking ability in order to enable high level of daily activities and social participation in adults with CP. Selective dorsal rhizotomy (SDR) is a valuable treatment option for a selective group of children with cerebral palsy (CP) in order to reduce spasticity. The long-term outcomes of SDR on level of accomplishment and satisfaction in daily activities and social participation as well functional mobility in adults with CP are not clear. More than 25 years after SDR adults with CP experienced stable and lasting high levels of functioning regarding daily activities and social participation and were satisfied with the way they accomplished life habits. Functional mobility was correlated to level of accomplishment and satisfaction in daily activities and social participation, which highlights the importance to focus rehabilitation programs on maintaining functional mobility in order to enable daily activities and social participation in adults with CP. [ABSTRACT FROM AUTHOR]