ABSTRACT
PURPOSE: The aim of this study was to describe functioning and health, and explore the use of the Gross Motor Function Classification System (GMFCS) in an adult population with cerebral palsy (CP). METHODS: From a cohort of 199 persons, 48 persons were selected for structured interviews and functional assessments regarding activities of daily living, motor function, range of motion, pain and general health. RESULTS: A third of the population had deteriorated in function from adolescence to adulthood according to the GMFCS. The majority were independent in personal ADL, but many of those were dependent in instrumental ADL. Motor function scores reflected problems in walking ability, and limited ROM and pain were common in all functional levels. General health was lower than in a general population. GMFCS seems valid for classifying adults with CP since it is correlated with instruments measuring motor function and ADL in terms of dependence. CONCLUSION: Decreased functional ability and secondary musculoskeletal problems are common in adults with CP and general health can be associated with those problems. It is important to further explore health aspects and relations between health status and self-perceived health. The GMFCS is a useful tool, especially for comparisons throughout the life span, but in order to use in an adult population further development is needed.
Subject(s)
Activities of Daily Living , Cerebral Palsy/classification , Adult , Cohort Studies , Educational Status , Female , Health Status , Humans , Male , Motor Activity , Pain , Range of Motion, Articular , Severity of Illness IndexSubject(s)
Automobile Driving , Brain Damage, Chronic/diagnosis , Brain Injuries/diagnosis , Neuropsychological Tests , Adult , Aged , Automobile Driver Examination , Brain Damage, Chronic/complications , Brain Damage, Chronic/psychology , Brain Hemorrhage, Traumatic/complications , Brain Hemorrhage, Traumatic/diagnosis , Brain Hemorrhage, Traumatic/psychology , Brain Infarction/complications , Brain Infarction/diagnosis , Brain Infarction/psychology , Brain Injuries/complications , Brain Injuries/psychology , Computer Simulation , Female , Humans , Male , Middle Aged , Models, Psychological , Reaction Time , Subarachnoid Hemorrhage, Traumatic/complications , Subarachnoid Hemorrhage, Traumatic/diagnosis , Subarachnoid Hemorrhage, Traumatic/psychologyABSTRACT
Twenty-nine patients with brain lesion and 29 matched controls participated in the study. The patients were socially well recovered with a high rate of employment. Compared with the controls, they performed significantly worse on a neuropsychological test battery, especially on executive and cognitive functions. Patients drove as well as controls in predictable situations in the advanced simulator used. In unpredictable situations, they demonstrated longer reaction times and safety margins, as well as difficulties in allocating processing resources to a secondary task. The patients showed significantly less attention, worse traffic behavior, and less risk awareness when driving in real traffic. Forty-one percent of the patients did not pass the driving test. The neuropsychological test battery was factor analyzed into four factors: executive capacity, cognitive capacity, automatic attentional capacity, and simple perceptual-motor capacity. The second factor was the mast significant with a simultaneous capacity test predicting driving performance with 78% confidence.
