Article

OBJECTIVE: To assess the prevalence, type, and impact of urinary problems in
adults with cerebral palsy and their relation with the Gross Motor Function
Classification System for cerebral palsy. DESIGN:
A cross-sectional prospective
survey study. SETTING: An outpatient, urban, academic rehabilitation clinic.
PARTICIPANTS: Ninety-one adults with cerebral palsy (45 women, 46 men).
INTERVENTIONS: Subjects were approached at clinic presentation and were
interviewed regarding current function, type and incidence of bladder issues, and
concerns with bladder problems. MAIN OUTCOME MEASURES: The International
Consultation on Incontinence Questionnaire-Female, or the International
Consultation on Incontinence Questionnaire-Male Lower Urinary Tract Symptoms
Module, Gross Motor Function Classification System, employment, and type of
residence. RESULTS: The mean age for both women and men was 36 years (range,
18-79 years). The subjects were currently assessed with the Gross Motor Function
Classification System scales I-V: I, 4.4%; II, 19.8%; III, 13.2%; IV, 40.7%; and
V, 22.0%. 95.6% of females and 84.7% of males were living at home. Twenty-three
percent were currently employed. Twenty percent of the women indicated that they
had bladder urgency most to all of the time and 46.7% of the women had leakage
that occurred 2-3 times per week to several times per day. In men, urgency that
occurred more often than "occasionally" was reported by 45.7%, and 19.6% reported
this occurred "most to all of the time." Multivariable analyses found that
obesity compared with normal weight was significantly related to leaking before
reaching a toilet (odds ratio [OR] 4.3, 95% confidence interval [CI] 1.3-14.7),
to leaking with cough, exercise, or sneeze (OR 5.6, 95% CI 1.3-23.1), and to
nocturia (OR 5.4, 95% CI 1.2-25.1). Women were more likely to leak with cough,
exercise, or sneeze (OR 5.5, 95% CI 1.5-20.0). On scales that indicate symptom
interference with life, high levels of interference were reported for women with
symptoms of leaking and for men with urgency and leaking. No significant
differences in living situation or employment were related to incontinence scores
for women or men. CONCLUSION: There are high levels of incontinence in adults
with cerebral palsy, and these individuals report interference with quality of
life. Despite these issues, most participants were living in the community, and
incontinence scores were not related to employment.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS