An important new study with recent published results aims to improve health services and care to children with cerebral palsy as they transition to adulthood. The study looked at health data for hundreds of children born since 1967 and diagnosed with cerebral palsy. Researchers found that some things, such as motor function, have improved in this population over time, while other disabilities have become more prevalent.
The Makeup of the Study
Researchers in Italy conducted this study, looking at information about cerebral palsy patients born between 1967 and 1997. They looked at how children who had been in care and discharged at the age of 18. The study included retrospective observational data from nearly 400 patients. The purpose of the study was to determine the clinical profile of young patients with cerebral palsy as they transition to adulthood and how that profile has changed over time.
The specific factors that the researchers looked at and measured to look for changes over time included risk factors and causes of the condition, the type of cerebral palsy, communication skills, motor and manual skills, and associated conditions.
Most of the patients in the study had spastic cerebral palsy, by far the most common type. Eighty-six percent had bilateral cerebral palsy, with both sides of the body impacted, and 57 percent were quadriplegic, with both the upper and lower half of the body affected by the condition. Almost half of the children needed total assistance, such as a wheelchair, for mobility.
The researchers found that it is very common for these patients to have associated conditions. More than half had an intellectual disability and sixty percent had visual impairment. Epilepsy occurred in 37 percent of the patients. Only five percent had hearing impairments.
Results Show Some Functions Have Improved, Others Declined
The results of the retrospective study showed some interesting trends in cerebral palsy over three decades. One is that the number of patients with better gross motor function increased from 47 to 56 percent. However, other factors became more prevalent over time, including intellectual disability, communication skills, and manual skills.
The researchers concluded that more patients over time have intellectual disabilities and poor manual and communication skills because more babies with severe disability survived. In the past life expectancy was shorter for these children. With advances in medicine and treatment more survive, but this increases the number of children with certain challenges and disabilities. Overall, the number of cerebral palsy patients needing full time care increased slightly.
Changes in Risk Factors and Treatments
The study also found shifts in what risk factors were in play in diagnoses of cerebral palsy and the treatment strategies most often used. What didn’t change is the fact that hypoxia, deprivation of oxygen during birth, and preterm birth are the most common risk factors for this condition. But, the study found that preterm birth rates decreased significantly. Unidentified causes of cerebral palsy rose correspondingly.
Surgery has long been an important treatment strategy for children with cerebral palsy, but the current study found that surgeries have actually declined. There has been an increase in non-surgical treatments, probably reflecting improvements in these less-risky treatment and therapy options.
The results of this study are important because they cast a light on how children living with cerebral palsy are functioning. The information will help researchers and caregivers develop better strategies for treatment and care. It will also help improve outcomes for patients and help more children transition to adulthood with greater independence.