A lifestyle intervention improves fatigue,mental health and social support among adolescents and young adults with cerebral palsy: focus on mediating effects
Restricted accessResearch articleFirst published online July, 2015
A lifestyle intervention improves fatigue,mental health and social support among adolescents and young adults with cerebral palsy: focus on mediating effects
To evaluate the effect of a lifestyle intervention on fatigue, participation, quality of life, gross motor functioning, motivation, self-efficacy and social support, and to explore mediating effects of physical behavior and physical fitness.
Design:
A randomized controlled trial with intention to treat analysis.
Setting:
Rehabilitation centers in university hospitals in the Netherlands.
Subjects:
Adolescents and young adults with spastic cerebral palsy.
Interventions:
A six-month lifestyle intervention that consisted of physical fitness training combined with counseling sessions focused on physical behavior and sports participation.
Main measures:
Fatigue, social participation, quality of life and gross motor functioning.
Results:
The lifestyle intervention was effective in decreasing fatigue severity during the intervention (difference = –6.72, p = 0.02) and in increasing health-related quality of life with respect to bodily pain (difference = 15.14, p = 0.01) and mental health (difference = 8.80, p = 0.03) during follow-up. Furthermore, the domain participation and involvement of the social support increased during both the intervention (difference = 5.38, p = 0.04) and follow-up (difference = 4.52, p = 0.03) period. Physical behavior or physical fitness explained the observed effects for 22.6%, 9.7% and 28.1% of improvements on fatigue, bodily pain and mental health, but had little effect on social support (2.6%).
Interpretation:
Fatigue, bodily pain, mental health and social support can be improved using a lifestyle intervention among adolescents and young adults with cerebral palsy. Furthermore, substantial mediating effects were found for physical behavior and physical fitness on fatigue, bodily pain and mental health.
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