Mobility and Gait in Adults with CP

Citation: Lennon N, Church C, Shrader M, Robinson W, Henley J, Salazar-Torres J, Niiler T, Miller F. Mobility and gait in adults with cerebral palsy: Evaluating change from adolescence. Gait and Posture. 2021;90:374-379.

Study type/population: Follow-up of 120 adults with cerebral palsy (CP), aged 25-45, GMFCS Level I-IV, who had instrumented gait analysis (IGA) in adolescence at a single facility. Participants completed PROMIS surveys (physical function, depression, participation, pain topics), and underwent further gait assessments and a physical examination in adulthood.

Key findings:  PROMIS scores for physical function were lower in adults with CP  than in age matched controls. No clinically meaningful changes were found in Functional Mobility Scale (FMS), Gross Motor Function Measure-D (GMFM-D) or gait velocity when comparing average adolescent to adult outcomes in patients grouped by GMFCS. However, significant outcome variability was noted (ie. on average, velocity was unchanged, but when assessed individually, 40% had reduced velocity as adults, while 37% had increased velocity as adults). as well as an association between more severe functional involvement and decline in gross motor function and walking velocity.

Translation to practice (what this study adds): In contrast to previous research, most adults in the study did not demonstrate meaningful/measurable decline in their mobility compared to when they were adolescents. This may suggest that specialist orthopaedic care (guided by IGA) may minimise change in mobility associated with aging for some adults with CP.