Secondary Disabilities of Adult with Cerebral Palsy Kazumi SATO* Abstract: A secondary disability is a disability occurring later in the course of the
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1 Secondary Disabilities of Adult with Cerebral Palsy Kazumi SATO* Abstract: A secondary disability is a disability occurring later in the course of the disease but not occurring during the occurrence of the primary disability, which is directly caused by the disease. It has been said that many adults with cerebral palsy suffer declines in their motor abilities owing to the secondary age-dependent complications. It is predictable that the problems regarding secondary disabilities will become more serious as more persons with cerebral palsy become aged. Psychosocial problems as well as issues on disorders of circulatory and respiratory function also have been pointed out recently, but this paper will mainly discuss actual conditions of orthopedic problems and the present state of treatments. A cervical spondylotic myelopathy is a typical musculoskeletal complication seen in an athetoid cerebral palsy. Abilities related to daily activities often decline significantly as the symptoms progress. Because it is progressive, conservative treatments cannot be counted on and a surgery will be necessary. It differs from ordinary cervical spondylotic myelopathies in that involuntary movements are existent, which brings about arguments over methods of operation. Other major orthopedic problems include hip dislocation and scoliosis, and many also complain of back pains or pains in weight bearing joints. In order for adequate prevention and treatment to be put into practice, adults with cerebral palsy and those concerned with them must have a proper understanding of secondary disabilities, and facilities need to be equipped as a place for adults with cerebral palsy to exercise and promote health.
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8 9) Murphy KP, Molnar GE, Lankasky K: Medical and functional status of adults with cerebral palsy. Develop Med Child Neurol 1995; 37: ) Schwartz L, Engel JM, Jensen MP: Pain in persons with cerebral palsy. Arch Phys Med Rehabil 1999; 80: ) Andersson C, Mattsson E: Adults with cerebral palsy: a survey describing problems, needs, and resources, with special emphasis on locomotion. Develop Med Child Neurol 2001; 43: 76-82
9 31) Cassidy C, Craig CL, Perry A, Karlin LI, Goldberg MJ: A reassessment of spinal stabilization in severe cerebral palsy. J Pediatr Orthop 1994; 14: ) Rimmer JH: Physical fitness levels of persons with cerebral palsy. Develop Med Child Neurol 2001; 43: ) Miller A, Temple T, Miller F: Impact of orthoses 41) Turk MA, Geremski CA, Rousenbaum PF, Weber on the rate of scoliosis progression in children with RJ: The health status of women with cerebral cerebral palsy. J Pediatr Orthop 1996; 16: palsy. Arch Phys Med Rehabil 1997; 78 suppl 5: 34) Terjesen T, Lange JE, Steen H: Treatment of S10-S17 scoliosis with spinal bracing in quadriplegic cere- 28) Thometz JG, Simon SR: Progression of scoliosis bral palsy. Develop Med Child Neurol 2000; 42: after skeletal maturity in institutionalized adults who have cerebral palsy. J Bone Joint Surg 1988; 35) Letts M, Rathbone D, Yamashita T, Nichol B, 70-A: Keeler A: Soft Boston orthosis in management of neuromuscular scoliosis: a preliminary report. J Pediatr Orthop 1992; 12:
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