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. 2022 Feb 10:12:771348.
doi: 10.3389/fneur.2021.771348. eCollection 2021.

The Use and Outcomes of Motor Rehabilitation Services Among People With Cerebral Palsy Change Across the Lifespan

Gwenaël Cornec  1   2   3 , Sylvain Brochard  1   2   3   4 , Gaelle Drewnowski  5 , Isabelle Desguerre  6 , Philippe Toullet  7 , Audrey Fontaine  8   9 , Yann Le Lay  10   11 , Julia Boivin  5 , Eric Bérard  12 , Maria Bodoria  13 , Vincent Gautheron  14 , Javier De la Cruz  15   16   17
Affiliations

The Use and Outcomes of Motor Rehabilitation Services Among People With Cerebral Palsy Change Across the Lifespan

Gwenaël Cornec et al. Front Neurol. .

Abstract

Background and aims: The provision of coordinated and multidisciplinary rehabilitation programs that adapt to the individual with cerebral palsy (CP) evolving rehabilitation needs throughout the different phases of life is highly challenging for healthcare systems. The aim of this study was to report the changes in motor rehabilitation (MR) environmental factors, service use and patient outcomes between children and adults with cerebral palsy and to identify if changes took place earlier or later than the standard division between pediatric and adult healthcare systems at 18 years.

Methods: We used data from the French ESPaCe survey to select a set of indicators for MR environmental factors, service use and patient outcomes, highlighted by patients and families in previous studies. We then compared the distribution of the indicator data between children and adults, as well as between four transition age groups: children under 12, adolescents up to 17 years, young adults, and adults over 25 years of age. We estimated odds ratios adjusted for motor involvement, associated impairments and informant type.

Results: A total of 997 respondents over 2 years of age were included in this study (484 children and 513 adults). Finding an available physiotherapist was very difficult for almost half of the children, and a greater proportion of adolescents and adults. Physiotherapy was provided in a private outpatient practice for twice as many adults over 25 years as children and adolescents. The weekly amount of physical therapy decreased as outpatient practice increased. Multidisciplinary rehabilitation decreased sharply from adolescence and was halved at adulthood. Satisfaction with the MR program decreased from childhood into adolescence and adulthood. Perceived impact of physiotherapy on people with CP and their main carers were less positive in adolescents.

Conclusions: Healthcare policies should focus on accessibility issues at all ages, consider adolescents as a specific population, consider a wide transition phase (12-25 yo) and maintain a multidisciplinary approach at adulthood. There is a strong need for national rehabilitation strategies for individuals with CP.

Keywords: adult neurology; cerebral palsy; disability; healthcare service; rehabilitation; transition to adult care.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Informant type: self-reported vs. proxy-reported by age.
Figure 2
Figure 2
Age distribution of Motor Rehabilitation Service Factors. Age categories according to (A) healthcare system (adult and pediatric), (B) transition age groups, and (C) according to adjusted age effect on multivariable analysis.
See this image and copyright information in PMC

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