Article

The aim of this systematic review was to identify, appraise and
synthesize the evidence describing gait decline in adults with cerebral palsy (CP). METHOD: Comprehensive searches were conducted in MEDLINE (1970-), EMBASE
(1980-), CINAHL (1982-) and AMED (1985-) databases to June 2012. Two reviewers
independently completed data extraction and analysis using a modified version of
the Downs and Black quality tool. RESULTS: From the 485 papers identified, 16 met
the inclusion criteria. Most studies used samples of convenience. The reported
mean ages of the study groups varied from 22 to 42.6 years. Decline in gait
function was measured variably with the period of decline undefined or from an
unknown reference time during childhood. Results suggest that mobility decline
occurs in 25% or more of adults with CP. Those at higher risk of gait decline are
those with worse initial gait ability, bilateral rather than unilateral motor
impairment, older age and higher levels of pain or fatigue. CONCLUSION: Many
ambulant adults with CP experience mobility decline earlier than their
nondisabled peers. More information regarding the natural history of mobility
change over the lifespan in adults with CP augmented with self-efficacy
qualitative data is needed to direct health advice and appropriate interventions
for this group. IMPLICATIONS FOR REHABILITATION:
The literature suggests 25% or
more of ambulant adults with cerebral palsy experience gait decline. Higher risk
of gait decline occurs in those who are older, less independent in gait, have
bilateral motor impairment and higher levels of pain or fatigue. Use of
standardized gait measurement tools augmented with self-efficacy measures will
aid provision of health advice and interventions.

Langue : ANGLAIS