An evaluation of factors contributing to employment in adults with cerebral palsy

Abstract

Purpose

To explore the impact of a selection of contributing factors on employment in adults with cerebral palsy (CP).

Method

Eighty adults with CP (39 male, median age 31, IQ > 70) were evaluated using standardized tests and questionnaires for hand function, gross motor function, pain, depressive symptoms, fatigue, social participation, performing daily activities, supportive materials, and mobility aids. Two separate analyses were performed. Firstly, differences between three subgroups were investigated: employee (n = 43), volunteer/sheltered (n = 14), and unemployed (n = 23). Secondly, multivariable regression analysis was applied to investigate the association between functional factors and employment hours.

Results

Compared to employees, volunteer/sheltered workers performed significantly slower hand function tasks (p < 0.001). Participants in the employee group had primarily MACS I (55.8%) or MACS II (44.9%) scores. The employee group showed significantly (p < 0.001) higher social participation and performance in daily activities. Thirty-eight percent of the variance in working hours could be explained by social participation, daily activities, fatigue, and gross motor function.

Interpretation

Employees are more likely adults with CP with better manual abilities. Sheltered/volunteer workers showed slower execution in hand function and higher limitations in fine motor skills. Social participation, performing daily activities, fatigue, and gross motor function are functional factors associated with hours of employment.

IMPLICATIONS FOR REHABILITATION

• Upper limb evaluation on ability and speed gives valuable information to decide whether to work on the regular labour market or choose for volunteer or sheltered work.

• The use of supportive materials on the work floor is low; however, they may compensate for less manual abilities of adults with cerebral palsy compared to their healthy peers.

• Improving social participation and daily activities, fatigue, and gross motor function may lead to higher working hours

Keywords:

• Cerebral palsy
• adults
• hand function
• employment
• participation
• spasticity

Acknowledgments

The authors would like to acknowledge the study participants for their time and efforts to perform the additional tests and complete the questionnaires.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data available on request from the authors

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.