Pain, Health-Related Quality of Life, and Mental Health of Adolescents and Adults with Cerebral Palsy in Urban South Africa
Abstract
PURPOSE: The aim of this study was to investigate the prevalence and level of disability due to pain, health-related quality of life (HRQoL) and mental health in adolescents and adults with cerebral palsy (CP), living in a low-to-middle income country (LMIC), compared to matched typically developing (TD) peers, and to explore associations with individual characteristics. MATERIALS AND METHODS: This case-control study included 31 adolescents and 30 adults with CP (gross motor function classification system [GMFCS] Level I-V) and matched TD peers. Assessment tools used were a pain questionnaire, the Oswestry Disability Index (ODI), Short-Form Health Survey (SF-36v2), Hospital Anxiety and Depression Scale (HADS), and General Self Efficacy (GSE) scale. RESULTS: Both CP cohorts reported more frequent pain in their lower limbs, higher level of disability due to pain (total ODI score) and lower perceived physical HRQoL compared to TD peers, while their mental health (mental HRQoL, HADS, and GSE) was not different. CONCLUSIONS: Despite the physical challenges faced by adolescents and adults with CP living in urban South Africa, the mental health scores showed no difference compared to TD peers. Care should be taken to maintain this positive mental state during ageing across their lifespan.IMPLICATIONS FOR REHABILITATIONThe prognosis of individuals with cerebral palsy (CP) has improved over the last three decades and CP should therefore be considered as a lifelong condition.Adolescents and adults with CP living in urban South Africa reported a higher level of disability due to pain and lower physical health-related quality of life compared to typically developing peers, while their level of depression, anxiety, and self-esteem was not different.These results were similar to findings of studies conducted in high-income countries, though it cannot be generalised to other low to middle-income countries with different cultural and government systems.In order to promote healthy ageing across their lifespan, intervention programmes should be considered to improve physical well-being, and care should be taken to maintain their positive mental health.
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In a sample of adolescents and adults with CP in urban South Africa, mental health scores were not different from typically developing children and adolescents.
“one study reporting on a sample of adolescents and adults in urban South Africa found that despite children with CP having physical challenges, their mental health scores were not different from typically developing children and adolescents [31].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [31]
A higher prevalence of chronic pain among adolescents with CP correlated with lower health-related quality-of-life scores.
“Researchers also found that a higher prevalence of chronic pain among adolescents with CP correlated with lower health-related quality-of-life scores [31]”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [31]
Individuals with CP often experience significant pain and lower health-related quality of life compared to the general population.
“Findings indicated that individuals with CP often experience significant pain and lower health-related quality of life compared to the general population.”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [31]
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- Authors
- Salie, R., Eken, M. M., Donald, K. A., Fieggen, A. G., & Langerak, N. G.
- Affiliations
- University of Cape Town (ZA)
- Stellenbosch University (ZA)
- Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Corresponding author
- Langerak, Nelleke Gertrude
- ORCID
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2021-04-28
- Volume
- 44
- Issue
- 17
- Pages
- 4672-4680
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W3159045348
- Cited by
- 14
- References
- 36
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 1
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Research Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Keywords
- cerebral palsy, pain, health-related quality of life, mental health, adolescents, adults, lower limb pain, self-efficacy, anxiety, depression, self-esteem, low- and middle-income countries, urban South Africa, healthy aging
- MeSH terms
- Adolescent, Adult, Cerebral Palsy, Humans, Mental Health, Pain, Quality of Life, South Africa, Case-Control Studies
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