Self-reported physical function is associated with walking speed in adults with cerebral palsy

Issue title: Cerebral Palsy

Guest editors: Michael M. Green and Deborah Gaebler-Spira

Article type: Research Article

Authors: Baer, Heather R.^{a; *; 1} | Thomas, Sruthi P.^{a; b; 1} | Pan, Zhaoxing^c | Tagawa, Alex^d | Carollo, James J.^{a; d} | Heyn, Patricia C.^{a; d}

Affiliations: [a] Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA | [b] Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA | [c] Research Institute, Children’s Hospital Colorado, Aurora, CO, USA | [d] Center for Gait and Motion Analysis, Children’s Hospital Colorado, Aurora, CO, USA

Correspondence: [*] Corresponding author: Heather R. Baer, University of Colorado School of Medicine, %****␣prm-12-prm180585_temp.tex␣Line␣100␣**** Department of Physical Medicine and Rehabilitation, 12631 East 17th Avenue, Academic Office 1, Room 2513, Aurora, CO 80045, USA. Tel.: +1 303 724 1264; Fax: +1 303 724 0863; E-mail: [email protected].

Note: [1] Co-first authors.

Abstract: PURPOSE: To understand the relationship of walking speed to self-reported pain, fatigue, and physical function in adults with CP. METHODS:Design: Cross-sectional study.Setting: Accredited clinical motion analysis laboratory in a regional children’s hospital.Participants: 72 ambulatory patients ⩾ 18 years of age, diagnosed with CP, who previously had ⩾ 1 prior instrumented gait analysis at our facility.Main Outcome Measures: PROMIS-57 pain interference/intensity, physical function, and fatigue measures and walking speed. RESULTS: Physical function was significantly lower than able-bodied normal values by 1–2 standard deviations (40.3 ± 8.5). Pain interference (51.4 ± 9.0) and fatigue (50.2 ± 9.2) were not significantly different when compared to able-bodied normal values. Only physical function was statistically correlated with walking speed (p< 0.001), while pain interference (p= 0.39), pain intensity (p= 0.36), and fatigue (p= 0.75) were not. Pain interference, pain intensity, and fatigue were not statistically significant factors in the multiple regression of walking speed. Fatigue could significantly predict physical function, pain interference, and pain scores (p= 0.032, p< 0.001, p< 0.01, respectively), however, fatigue did not directly predict walking speed (p= 0.747). CONCLUSIONS: Self-reported physical function correlates with objectively measured walking speed in young adults with CP while patient-reported pain and fatigue did not, contrary to what would be predicted by the literature.

Keywords: Cerebral palsy, adult-outcomes, PROMIS, physical function, pain, fatigue, walking speed

DOI: 10.3233/PRM-180585

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 2, pp. 181-188, 2019