The level of accomplishment and satisfaction in activity and participation of adults with cerebral palsy and spastic diplegia

Background Orthopaedic surgery is commonly performed in children with cerebral palsy (CP) and spastic diplegia to improve functional mobility. However, no research has quantified levels of accomplishment and satisfaction in daily activities and participation long-term after surgery. Therefore, this study aimed to investigate 1) the level of accomplishment and satisfaction of life habits in adults with CP, 2) whether there were differences between Gross Motor Function Classification System (GMFCS) levels, and 3) associations with contextual factors, functional level and frequency of pain. Methods Levels of accomplishment and satisfaction in activity and participation were assessed using the Life-Habits 3.1 questionnaire in 30 adults with CP and spastic diplegia who received the first orthopaedic intervention more than 15 years ago. GMFCS and Functional Mobility Scale (FMS) described the function level. Participants reported frequency of back pain and pain in the lower limb and the upper limb. Results On average 63% of the participants were independent and faced no difficulties in the accomplishment of all life habits. Difficulties were mostly experienced for ‘mobility’, ‘housing’ and ‘recreation’. Participants were overall satisfied, with lowest scores for ‘employment’. Between the GMFCS levels, there was only a difference for the total accomplishment score of participants with level I and II. In addition, negative associations were found between accomplishment of life habits and GMFCS level, FMS, and pain on spinal level. Conclusion Levels of accomplishment and satisfaction were relatively high among adults with CP who underwent orthopaedic interventions during childhood. However, negative associations between accomplishment levels and level of functioning and back pain argue for rehabilitation programs specialized on these factors. This information is imperative for physicians and allied health care professionals to guide adults with CP during ageing.