Fatigue and sleep in adults with cerebral palsy: feasibility of two self-guided neurocognitive rehabilitation programmes to support self-management.

Abstract

Fatigue and sleep problems affect daily life in adults with cerebral palsy (CP). Self-guided interventions supporting self-management are promising but not evaluated in this population. We assessed feasibility and preliminary efficacy of two self-guided neurocognitive rehabilitation modules targeting fatigue and sleep in adults with CP. Feasibility was evaluated across adoption, adherence, acceptability and satisfaction using predefined thresholds. Fatigue and sleep were measured pre- and post-modules using self-report (scale 1-10), real-time fatigue, and bed sensor data. Outcomes were examined descriptively. Twenty-two adults with CP (mean age 44 (24-63); GMFCS I-III: 14 participants; GMFCS IV-V: 2 participants; unknown: 6 participants; 7/22 male) engaged with the modules, with 17/22 participants independently completing both. Satisfaction averaged 6.5, below the threshold of seven. The fatigue module met acceptability criteria, whereas the sleep module did not (53% vs benchmark ≥ 70%). Post-module self-reported fatigue decreased, supported by real-time fatigue data showing less fatigue, particularly in early mornings. Sleep quantity and quality remained stable, with high baseline sleep quality. Self-guided neurocognitive rehabilitation is feasible for adults with CP and shows promise for managing fatigue. Larger studies are warranted to evaluate implementation and effectiveness across varying mobility and cognitive functioning.