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Adults with Cerebral Palsy - How you are doing?

By completing this survey you will help us to better understand what the adult Cerebral Palsy population looks like in South Africa. This is the first step in working towards better care!

Thank you for your participation!

Age (years):

* must provide value

Sex:

* must provide value

Race:

* must provide value

Where do you live currently?

* must provide value

Have you been diagnosed with Cerebral Palsy?

* must provide value

Yes

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What area of your body has been affected by Cerebral Palsy?

* must provide value

Both of my legs

One side of my body (arm and leg)

My whole body

Other

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What part of your body is affected by Cerebral Palsy?

* must provide value

How do you move around?

I can walk on my own

I need assistance to walk (crutches, walker, support from a person)

I push myself in a wheelchair

Someone else pushes me in my wheelchair

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Do you experience muscle stiffness or spasms in the parts of your body affected by Cerebral Palsy?

* must provide value

Yes

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How old were you when the muscle stiffness or spasms started? (years)

How does your muscle stiffness or spasms affect you?

I have difficulty with movement

I have difficulty cleaning myself

I have difficulty talking or swallowing

I have contractures (joints that are stuck and can't move anymore)

I have needed surgery (eg. for contractures, bedsores or wounds)

It has resulted in falls

It has resulted in me needing medical treatments (eg. for infections or blood clots)

Other

In what other ways does your muscle stiffness or spasms affect you?

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Does your muscle stiffness or spasms require you to have a caregiver?

Yes

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What does your caregiver help you with?

Eating

Grooming (doing your hair or brushing your teeth)

Bathing

Dressing upper body

Dressing lower body

Toiletting

Other

In what other ways does your caregiver assist you?

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I go to a Doctor regularly for my symptoms of Cerebral Palsy?

Yes

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I don't see a Doctor regularly because:

Its too hard to get there

I can't afford it

I don't know which Doctor to go to

I don't have time

There's no point, medication doesn't help

Other

For what other reasons don't you see a Doctor regularly?

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Do you recieve any treatment from a Doctor for your muscle stiffness or spasms?

Yes, but I am not sure what the medicine is for

I take prescribed medicine (tablets)

I self medicate (tablets)

I get Botox injections

Do you take any of these medications for your muscle stiffness or spasms?

Baclofen

Benzodiazepines

Lyrica

I am not sure

Other

Which other medications do you take for your muscle stiffness or spasms?

Do you take any UNPRESCRIBED medications/drugs for your muscle stiffness or spasms?

Yes cannabis (dagga; cannabis oils)

Other

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Which other UNPRESCRIBED meds do you take for your muscle stiffness or spasms?

How intense do you feel your muscle stiffness or spasms are out of 10, where 0 is no muscle stiffness/spasms, and 10 is as bad as you can imagine?

Change the slider above to set a response

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How much pain is caused by your muscle stiffness or spasms out of 10, where 0 is no pain, and 10 is the worst pain ever experienced?

Change the slider above to set a response

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Do you receive any medication for the PAIN caused by your muscle stiffness or spasms?

I take prescribed medication for the pain

I self medicate for the pain

How does your muscle stiffness or spasms affect the amount of movement you have in your legs?

It does not affect the amount of movement I have in my legs

My legs pull together and it is hard to pull them apart

My knees are bent and cannot straighten all the way

My feet pull into abnormal positions

The muscle stiffness or spasms of my legs:

makes it difficult for me to walk

prevents me walking

makes it difficult to put on pants and shoes

makes it difficult to clean myself

none of the above

The muscle stiffness or spasms of my arm/s:

does not affect the amount of movement I have in my arms

makes it hard to lift my arm over my head

makes it hard bend or straighten my elbow all the way

makes it hard to bend or straighten my wrist and fingers all the way

The muscle stiffness or spasms of my arm/s make it difficult to:

use my arms/hands to feed myself

write or type

get dressed

clean myself

use my arms for support

none of the above

My muscle stiffness or spasms also:

Makes me feel sad

Makes me anxious

affects my sleep

affects my ability to earn an income

none of the above

My muscle stiffness or spasms is at its worst in the:

Morning

Afternoon

Evening

Night

There is no difference throughout the day

Did you attend school where physical therapy was provided?

Yes

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For how many years did you attend this school?

Are you currently receiving any form of regular rehabilitation therapy? (At least once per month)

Yes

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How often do you attend any form of rehabilitation therapy?

More than once per week

Once per week

Twice per month

Once per month

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What forms of therapy are you getting regularly?

Physiotherapy

Occupational Therapy

Speech Therapy

Biokinetics

Chiropractics

Reflexology

Psychology

Other

What other forms of therapy are you getting?

Why are you not getting regular therapy?

I don't need any therapy

It's too hard to get there

It's too expensive for me

I do not know where to get help

I don't have time

Nobody can take me

Therapy is too uncomfortable

Therapy doesn't help

Other

For what other reasons do you not get regular rehabilitation therapy?

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Are you currently on a medical aid?

Yes

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Does your medical aid cover the costs of therapy?

Yes

I don't know

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If you would like to participate in further studies in this field please contact me on meghan.noble@ndphysio.co.za

Thank you for your participation!

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.