Quality of Life in Children and Young People with Cerebral Palsy: A Meta-analytic Review

Abstract

Background: Cerebral Palsy (CP) is a chronic neurodevelopmental disorder that can significantly impact on the quality of life (QoL) of affected children and adolescents. However, inconsistencies in the measurement of QoL confound this literature. Aims: To examine QoL ratings in children and adolescents with CP relative to typically developing peers based on measures that are reliable and valid for this cohort. Methods: Fourteen eligible studies, comprising a pooled sample of 2,042 children and adolescents with CP and 55,222 controls were identified from a search of the Embase, PsycINFO, PubMed, Scopus and Web of Science electronic databases. The reporting quality of included studies was examined (QualSyst tool) and standardised mean group differences (Hedge’s g), with 95% confidence intervals and fail-safe N statistics calculated. Heterogeneity indices included Cochran’s χ2 (Q), I-squared (I2) and tau (T). Both random and mixed-effects models were adopted. Results: Although QoL ratings indicated greater impairment in physical functioning for those with CP, subjective ratings of psychological and social functioning were comparable to peers without a disability. Conclusions: QoL is not necessarily reduced in children and young people with CP. Routine measurement of QoL is important in order to ensure comprehensive care for this cohort. Further research targeting those with a severe degree of physical behavioural and/or emotional impairment also is needed to confirm the generalisability of the present findings and differential impacts of CP on life domains.