Factors related to motor outcomes in adolescents and adults with cerebral palsy: A systematic review

Abstract

Background

Although the brain injury caused by cerebral palsy (CP) is not progressive, there is often a worsening of physical conditions during the transition to adolescence and adulthood. The aim of this systematic review was to summarize factors related to decline in motor function in adolescents and adults with CP.

Methods

This review was registered in PROSPERO (CRD42022311783). Studies met the following criteria: participants diagnosed with CP, ages 10 to 59 years; scientific studies with any methodological design and emphasis on motor function, reporting quantitative analysis of the effect of age on motor function or factors relevant that declined or improved motor capacity; published in English; any publication year, in electronic databases: Pubmed/Medline, Scopus, Cinahl. Data selection and extraction used the Covidence software. Factors related to motor outcomes that were statistically significant in at least one study and present in more than one study were reported. The outcomes were grouped within major categories (gross motor function, neuromusculoskeletal functions, and gait) for summary.

Results

23 studies met the inclusion criteria. Relevant factors for changes in gross motor function (n = 16 studies) were: pain, neuromusculoskeletal aspects, altered gait parameters, Gross Motor Function Classification System (GMFCS) level, age, and history of surgery; for gait (n = 11): mobility performance, altered gait parameters, age, GMFCS level, pain and neuromusculoskeletal aspects; and for neuromusculoskeletal functions (n = 4): altered gait parameters, neuromusculoskeletal aspects, age, pain, and GMFCS level.

Conclusion

Age, GMFCS level, and presence of pain stood out as significant for motor decline across categories. Monitoring these factors is relevant for planning interventions and transition programs.