A 16-year follow-up of walking function, fatigue, and pain in adults aged 34–65 years with spastic cerebral palsy

This study aimed to describe the long-term changes in walking function, fatigue, and pain in adults with cerebral palsy. A 16-year follow-up study with paired comparisons. Adults with spastic cerebral palsy (n = 29) from a baseline study in 2008. The mean age at follow-up was 50 (standard deviation 10) years. Gait Deviation Index, 6 Minute Walk Test, Timed-Up-and-Go test, walking speed, Fatigue Severity Scale, and bodily pain (visual analogue scale, 0-100). Paired samples t-test (Wilcoxon signed rank test for non-parametric data) was used to assess differences between baseline and follow-up. Between-group differences were analysed using an independent samples t-test (Mann-Whitney U test for non-parametric data). Mean gait pattern deviations significantly (p-value = < 0.001) increased at follow-up compared with baseline for the full cohort. Walking speed decreased for the full cohort (-0.08 m/sec, p-value = 0.022), due to the bilateral group (-0.13 m/sec, p-value = 0.006). Walking capacity was maintained for the full cohort but decreased (mean diff: -84m, p-value = 0.035) for the bilateral group. Fatigue remained stable (p-value = 0.888). Pain decreased (p-value = 0.025) for the whole group, primarily due to the unilateral group (mean diff: 14 points on visual analogue scale, p-value = 0.031). Gait pattern deviations increased for adults with cerebral palsy during this 16-year follow-up. Walking speed and capacity decreased for the bilateral group but were maintained for the unilateral group. Fatigue symptoms were high at baseline but did not change across this follow-up. Pain decreased, similar to the general population.