Cerebral Palsy, or CP, is a disorder that affects the way an individual is able to move. A research team led by Désirée B. Maltais wrote the paper “Health-related physical fitness for children with cerebral palsy.” More specifically, the research analyzed was about three physical activity attributes related to health. They were cardiorespiratory endurance, muscle strength, and anaerobic fitness. To draw conclusions about these attributes in relation to cerebral palsy, researchers analyzed systematic reviews and relevant research papers on these topics to draw conclusions about each one.
Results from this research paper varied based on the physical fitness attribute. For cardiorespiratory endurance, the researchers concluded that children with cerebral palsy may have a larger chance of developing cardiovascular diseases than children who don’t have cerebral palsy because their cardiovascular endurance is lower. This deficiency in cardiorespiratory endurance increases with age for girls and children with more significant mobility limitations, putting these two groups at a much greater risk for cardiovascular diseases. Recent studies on the topic of aerobic exercise training show that it can result in a significant increase in cardiorespiratory endurance, especially when the intervention period is long. One study required participants to exercise 2-3 times a week, at least 30 minutes a day. The increase in cardiorespiratory endurance was as follows: 23% for an 8-week intervention, 15% for a 3-month intervention, 40% for an 8-month intervention, and 28% for a 9-month intervention (Maltais et al., 2014). These results were especially heightened for children with cerebral palsy that had greater mobility. Not only did this training lead to more cardiorespiratory endurance, but also increased the mobility capacity. However, these changes do not promise a lasting effect on children as many of them lost this new level of cardiorespiratory endurance and mobility capacity within the first four months after the experiment (Maltais et al., 2014). That is not to say that aerobic exercises aren’t beneficial for the children at all, rather, relying solely on them will not sustain children with cerebral palsy.
As for muscle strength, seven studies on the effectiveness of lower extremity strengthening interventions showed that there is data in support of the notion that this intervention increases the ability to produce torque, but it’s not quite supportable for functional activities. Despite that, the authors still think it’s a procedure that should be performed for children with cerebral palsy. Moreover, 12-week randomized controlled trials using functional exercises sought to understand what are the better exercise parameters for children with cerebral palsy. It was found that strength training for children with cerebral palsy did lead to an increase in strength (Maltais et al., 2014). However, the effects of exercise interventions on improving mobility and other functions like gait function aren’t conclusive by current research. Current practices in relation to muscle strength are in accordance with the National Strength and Conditioning association guidelines for children. The guidelines recommend single-joint exercise protocols for children with cerebral palsy. If these procedures prove difficult due to complications of isolating joint motion, strengthening and electrical simulations can also be used to increase muscle size (Maltais et al., 2014).
Research in regards to anaerobic exercises has been a little more limited. Maltais et al. (2014), suggests that current research includes van den Berg-Emons et al (1998)’s findings, which concluded that peak anaerobic power isn’t affected by training, even after a nine-month aerobic exercise intervention. The Muscle Power Sprint Test was also a study that tried to examine anaerobic activity and its effects on children with cerebral palsy. It also consisted of exercise intervention that lasted eight months, the last five being centered around anaerobic fitness. The researchers found improvements in both anaerobic fitness and cardiorespiratory endurance after the completion of the exercise intervention.
Overall, research and evidence point to all three physical fitness attributes being beneficial to children with cerebral palsy. Working with a knowledgeable practitioner can help children with cerebral palsy integrate these aspects into their life at the right level and gain as many benefits as possible. Keep in mind that these fitness improvements will not always correlate with better mobility, which could be affected by the types of exercise training that individuals are participating in. It’s also important to note that while these new exercise interventions might help individuals, there’s not much known on how to maintain these improvements in the long run.
There are many advantages and disadvantages to health-related fitness. Some advantages are that health-related fitness can be customized to a patient’s needs and that later in life if these methods are used, those individuals are more likely to have more mobility than the average person with cerebral palsy. Some disadvantages are that there is often a lack of resources when attempting to perform these methods and that health-related physical fitness has not been officially proven to work.
As cerebral palsy is a disease that restricts people from movement, causing long periods of immobility, health-related physical fitness is very beneficial to a cerebral palsy patient’s well-being. Therapists who work with children with cerebral palsy can start introducing forms of exercise into their daily routines to build up strength and give the body a chance to grow and get stronger, even when disabled. Research has shown that people with cerebral palsy who stayed active in their childhood and adulthood were less likely to have a large amount of mobility loss later in life (Maltais et al., 2014). This is incredibly important because although they are still not fully mobile, they can move around much better and easier than those who did not stay active.
Another advantage is that these training procedures can be easily modified to the patient’s needs as there is no “one size fits all.” For example, suppose a child would prefer a shorter, high-intensity workout instead of a longer, low-intensity one. In that case, it is easy to accommodate since there is a wide variety of exercises and training that trainers can arrange. Children and parents can pick between group or individual training, different programs, locations, settings, and activities that would help the patient and provide them with a good quality of life.
Aside from helping the patients physically, these methods also help them socially. If patients are involved in group-based activities, children get to socialize with other people and form close bonds.
The problem with health-related physical fitness in people with cerebral palsy is that there might be a lack of required resources to perform these techniques. These limiting factors include, but are not limited to not enough trainers or therapists, areas that would be hard to access, lack of modified equipment specially made to fit the needs of the patient or patients, unawareness in the community that training sessions are available, inability to access transportation, and the cost of membership. The existence of these factors makes it hard for people with cerebral palsy, unsure of what they should be doing, to incorporate exercise in their lives.
These methods are also not proven to completely work. This means there is still a lot of research needed to be done around these exercises before allowing them to be clinical practices.
APA Format Citation:
Maltais, D. B., Wiart, L., Fowler, E., Verschuren, O., & Damiano, D. L. (2014). Health-related physical fitness for children with cerebral palsy. Journal of child neurology, 29(8), 1091–1100. https://doi.org/10.1177/0883073814533152
