van Gorp Marloes, Dallmeijer Annet J, van Wely Leontien, de Groot Vincent, Terwee Caroline B, Flens Gerard, Stam Henk J, van der Slot Wilma, Roebroeck Marij E
Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Disabil Rehabil. 2021 Jul;43(15):2164-2171. doi: 10.1080/09638288.2019.1694998. Epub 2019 Dec 6.
Investigate pain, fatigue, depressive symptoms and sleep disturbance in young adults with cerebral palsy compared to references.
Young adults with cerebral palsy ( = 97, aged 21-34 years) and age-matched references from the general population ( = 190) rated pain using a numeric rating scale and fatigue, depressive symptoms, sleep disturbance and global health using Patient-Reported Outcomes Measurement Information System® short forms. Scores were compared between cerebral palsy subgroups and the reference population. Correlation coefficients and linear regression analyses assessed interrelationships of health issues and associations with global health.
Individuals with Gross Motor Function Classification System level I had less pain, fatigue and depressive symptoms, while individuals with levels II and III-V had more pain (53% and 56%, < 0.001) and those with levels III-V more fatigue (39%, = 0.035) than references (pain: 26%, fatigue: 14%). Pain and fatigue were more interrelated (correlation coefficients: 0.71 vs. 0.41) and stronger associated with global mental health in individuals with cerebral palsy.
Young adults with Gross Motor Function Classification System levels II-V report more pain and those with levels III-V report more fatigue than references. Pain and fatigue are highly interrelated and specifically relate to mental health in individuals with cerebral palsy.Implications for rehabilitationExcept for those in the highest level of motor function, young adults with cerebral palsy report higher levels of pain and fatigue compared to the general population of the same age.Pain and fatigue are strongly interrelated and associated with mental health in young adults with cerebral palsy.The present study recommends to monitor pain and fatigue in young adults with cerebral palsy with low levels of gross motor function.We advise rehabilitation professionals to consider combined treatment for both pain and fatigue.
与对照组相比,调查年轻脑瘫患者的疼痛、疲劳、抑郁症状和睡眠障碍情况。
年轻脑瘫患者(n = 97,年龄21 - 34岁)和来自普通人群的年龄匹配对照组(n = 190)使用数字评分量表评估疼痛情况,并使用患者报告结局测量信息系统®简表评估疲劳、抑郁症状、睡眠障碍和整体健康状况。比较脑瘫亚组与对照组人群的得分。相关系数和线性回归分析评估健康问题之间的相互关系以及与整体健康的关联。
粗大运动功能分类系统I级的个体疼痛、疲劳和抑郁症状较少,而II级和III - V级的个体比对照组有更多疼痛(分别为53%和56%,P < 0.001),III - V级的个体有更多疲劳(39%,P = 0.035)(对照组疼痛:26%,疲劳:14%)。疼痛和疲劳在脑瘫患者中相关性更强(相关系数:0.71对0.41),且与整体心理健康的关联更强。
粗大运动功能分类系统II - V级的年轻脑瘫患者比对照组报告更多疼痛,III - V级的患者报告更多疲劳。疼痛和疲劳高度相关,且在脑瘫患者中尤其与心理健康相关。
康复启示
除运动功能最高水平的患者外,年轻脑瘫患者比同年龄普通人群报告更高水平 的疼痛和疲劳。
疼痛和疲劳在年轻脑瘫患者中密切相关且与心理健康有关。
本研究建议监测粗大运动功能水平低的年轻脑瘫患者的疼痛和疲劳情况。
我们建议康复专业人员考虑对疼痛和疲劳进行联合治疗。