Real-time daily fatigue, sleep, physical activity, and health-related fitness in adults with cerebral palsy
Citation: Verschuren O, Benner JL, Balemans ACJ, Horemans H, Van Den Berg-Emons RJG, Van Der Slot WMA. Real-time daily fatigue, sleep, physical activity, and health-related fitness in adults with cerebral palsy. Dev Med Child Neurol. 2022 Sep 26. doi: 10.1111/dmcn.15421.
Study type/population: Observational study of 32 adults with spastic CP (age range 20-54yo; GMFCS Levels I-III). Daily assessment of fatigue (rated between 0 – 10; from none to severe) was performed four times a day, for seven days. Daily measures of physical activity (accelerometer) for seven days, and completion of sleep quality questionnaire (Pittsburgh Sleep Quality Index) and fitness outcomes (body composition and aerobic capacity) were also performed. An average daily ‘real time fatigue score’ was calculated out of 10.
Key findings: Later in the day (5pm and 9pm), 22 adults with CP were at the higher end of moderate or lower end of severe fatigue (fatigue scores 5.3–7.3/10). Three different patterns of daily fatigue were identified: stable low (n=10), increasing throughout the day (n=14) and stable high (n=8). There were no significant differences in physical activity, sleep quality, or body composition between people with CP in these three fatigue profiles. Only aerobic capacity was associated with fatigue. Those with higher aerobic capacity were more likely to be in the increasing throughout the day than the stable low group.
Translation to practice: Fatigue in adults with CP may be low or high stable, or may increase during the day. These findings suggest the importance of assessing fatigue variability.