Irene L.B. Oude Lansink, Patrick G. McPhee, Laura Kristine Brunton, Jan Willem Gorter
Department of Rehabilitation Medicine, University Medical Center Utrecht, 3508 AB Utrecht, The Netherlands.
DOI: 10.2340/16501977-2493

Objectives: To describe the course of fatigue over a 3-year follow-up period in adults with cerebral palsy and to investigate the association of known determinants of fatigue (i. e. demographic characteristics and/or body composition) with change in fatigue.
Methods: Forty-one adults with cerebral palsy from a previous study of fatigue were invited to participate in a follow-up study. Twenty-three adults with cerebral palsy (Gross Motor Function Classification System (GMFCS) levels I–V; mean age 38 years 2 months, standard deviation (SD) 14 years 1 month)) agreed to participate (convenience sample). Fatigue was measured with the Fatigue Impact and Severity Self-Assessment (FISSA, range 31–157) questionnaire. The course of fatigue is described at group, subgroup (GMFCS) and individual levels.
Results: The mean FISSA score for all participants was 84. 0 (SD 27. 7) at baseline and 91. 7 (SD 26. 7) at follow-up. Despite variations among individuals in the change of fatigue, there was no statistically significant difference in FISSA score over time (p = 0. 087, 95% confidence interval (95% CI) –16. 7 to 1. 22). No known determinants of fatigue predictive of change in FISSA scores were found.
Discussion: Fatigue appears to be relatively stable within adults with cerebral palsy over time, with a variable presentation between individuals and across GMFCS levels. Care providers should monitor and discuss fatigue in young individuals with cerebral palsy in order to attenuate fatigue later in life.

People with cerebral palsy are often tired and may complain about fatigue. In this study we describe the development of fatigue over a mean period of 3 years. We found that fatigue is more or less stable over time on a group level. On an individual level there can be important changes, both increases and decreases in fatigue-related symptoms. We did not find any known risk factors for fatigue (for example body mass index, age) to be predictive of change in fatigue over time. We learned that adults with CP, who experience fatigue, are likely to remain fatigued in the future. We therefore think it is important for care providers to monitor and talk about fatigue with adults with CP. We would suggest care providers begin this discussion at a much younger age to influence fatigue later in life.