Prevalence of fatigue in adolescents and adults with cerebral palsy: a systematic review and meta-analysis

Fatigue is a common problem for adults with cerebral palsy (CP) and may be related to the decline in physical function, including the loss of the ability to walk. To estimate the overall prevalence of fatigue in adolescents and adults with cerebral palsy. MEDLINE (OVID), EMBASE (OVID), CINAHL, PsycINFO, and Web of Science electronic databases were searched in September 2021. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration CRD42021275596. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Checklist. Of the 1022 studies identified, fifteen met the inclusion criteria. Study quality assessment was performed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Checklist, with scores ranging from 4 out of 10 to 10 out of 10. Pooled prevalence estimates for twelve studies were 52.9% (95% confidence interval [CI]40.9–64.6). Fatigue was higher in people with bilateral CP than unilateral CP, and higher in people classified as Gross Motor Function Classification System (GMFCS) levels III-V. More than half of the adults with CP (52.9%) reported living with fatigue. Adults with CP frequently reported fatigue that may lead to activity limitations and/or restrictions. Fatigue was strongly correlated with pain, depression, and reduced quality of life. Assessment and appropriate fatigue management techniques are necessary to enhance capacity for everyday functioning and quality of life.