Changes in Walking Performance between Childhood and Adulthood in Cerebral Palsy: A Systematic Review

Purpose: To examine the changes in walking performance between childhood and adulthood in cerebral palsy. Methods: Cohort studies were included if the participants were children with cerebral palsy at Gross Motor Function Classification System (GMFCS) Level I-IV, initial measurement of walking by 13 years of age and follow-up measurement by 30 years of age. Results: At GMFCS Level I+ II, 7% (95% CI 6-8) had declined to GMFCS Level III. At GMFCS Level III, 4% (95% CI 3-6) had declined to GMFCS Level IV and 31% (95% CI 27-34) had improved to GMFCS Level I+ II. At GMFCS Level IV, 2% (95% CI 1-4) had improved to GMFCS Level III and 3% (95% CI 2-4) had improved to GMFCS Level I+ II. Discussion: The results suggest that walking performance is stable from childhood to adulthood at either end of the spectrum of ability but is more changeable for intermediate walkers.