Pain, fatigue, and sleep disturbances in young adults with cerebral palsy

Introduction: Adults with cerebral palsy (CP) often report pain and fatigue, but insight is lacking regarding these health complaints in younger adults compared to references, and associations with sleep disorders and perceived health. Patients and Methods: Young adults with CP (n=97, 28y 6mo [3y 9mo], 51% GMFCS level I, no intellectual disability) participated. Pain was assessed with a numeric rating scale, and fatigue, sleep disturbance, and global physical and mental health using PROMIS (Patient Reported Outcome Measurement Information System) short forms. Regression analyses were used to evaluate differences in the prevalence of health issues, interrelationships, and associations with perceived health between individuals with CP and age-matched references. Results: Young adults in GMFCS levels II to V reported more pain and fatigue (54%, 46%) compared to references (26%, 37%), whereas individuals in GMFCS level I reported less pain and fatigue (8%, 6%). Proportions of persons with sleep disturbances (28%) were similar to references (34%). Pain and fatigue were more strongly associated in persons with CP (std beta 0.81) than in the references. In persons with CP these health issues correlated most strongly to perceived mental health (std beta -0.83, -0.74). Conclusion: Individuals with CP in their twenties in GMFCS levels II to V report more pain and fatigue than references, while those in GMFCS level I report these less often. Pain and fatigue are notably interrelated in young adults with CP and affect their perceived mental health. Health professionals should monitor pain and fatigue in individuals in GMFCS levels II to V, and may consider treatment options for both issues in combination.