Musculoskeletal health among adults with cerebral palsy: A systematic review.
Jennifer M Ryan, Jessica Burke, Rachel Byrne et al.
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In 30 seconds
This systematic review examined the burden and prognostic factors of musculoskeletal disorders, monitoring protocols, and osteoarthritis interventions in adults with cerebral palsy (CP). Searches of six databases identified 44 reports. Compared with adults without CP, adults with CP had a higher burden of osteoarthritis, osteoporosis, and fracture, although certainty was low to moderate. Osteoporosis/osteopenia was more prevalent at Gross Motor Function Classification System levels IV and V than levels I to III. Evidence on monitoring and treatment effectiveness was limited.
Key findings
- Osteoarthritis, osteoporosis, and fracture were more common in adults with CP than in adults without CP; evidence certainty was low to moderate.
- Osteoporosis/osteopenia was more prevalent at Gross Motor Function Classification System levels IV and V than levels I to III.
- Monitoring protocols identified scoliosis progression and hip displacement, but no study compared monitoring with no monitoring.
- Very low-certainty evidence from one study suggested total hip arthroplasty improves pain and function in adults with CP and osteoarthritis.
Why it matters
The review highlights substantial musculoskeletal health needs in adults with CP, while showing that evidence to guide risk assessment, monitoring, and osteoarthritis management remains limited. Recognising the reported burden can inform clinical attention to these disorders, but uncertainty about effective monitoring and interventions constrains conclusions about how best to reduce their impact.
What to keep in mind
Evidence certainty was low to moderate for comparative burden and very low for hip arthroplasty; no study compared monitoring with no monitoring.