Walking in adults with spastic cerebral palsy : the relation to pain, fatigue, gait and balance

Background: Cerebral palsy (CP) is a disorder of movement and posture, and reduced gross motor function has been reported in several studies. Walking is an important function in everyday life, and important for independence. Studies on walking deterioration in adults with spastic CP are lacking. Objectives: The main aim of this thesis was to investigate walking over a seven year period, to characterise and investigate the critical variables associated with walking deterioration, the changes in these variables over seven years, and to compare and characterise gait and balance in relation to walking deterioration. Methods: Studies I and II were seven-year follow-up studies (N=149) using the same questionnaire as previously. Self-reported walking deterioration was assessed and compared. Pain, fatigue and gross motor function were compared over seven years, and the relationship between these variables and walking deterioration was examined (Study I). The relationship between number of pain sites and mental and physical components of Health-Related Quality of Life (HRQoL) was investigated, as well as pain site prevalence (Study II). For the inclusion to Studies III and IV, individuals in the critical age and sub-diagnosis for walking deterioration were identified. Three-dimensional gait analysis was used to obtain work of walking and kinematic gait variables in adults with spastic bilateral CP,