Self-perceived fatigue in relation to activity and participation in adolescents and adults with cerebral palsy living in urban South Africa.

The study used a convenience sample of adolescents and adults living in urban Cape Town, which limits the generalizability of findings to all individuals with CP in low-to-middle income countries. The cross-sectional design prevents conclusions about causality or how fatigue changes over time during the transition from adolescence to adulthood. The Fatigue Severity Scale is a unidimensional self-report measure and may not capture the multidimensional nature of fatigue or account for cultural differences in reporting symptoms. The sample size was relatively small, which may have reduced the power to detect subtle associations.

The study was funded by the National Research Foundation, Gabriel Foundation, Mauerberger Foundation, and the Neuroscience Institute at the University of Cape Town. The authors declared no potential conflicts of interest.

Do not conclude that fatigue is irrelevant to patients with CP based on this study. The null finding applies specifically to a South African urban cohort where contextual factors like high physical demands or different coping mechanisms may mask fatigue's impact. Clinicians in high-income settings should still monitor for fatigue, as previous literature consistently links it to reduced participation in those contexts.