Chronic disease risk among adults with cerebral palsy: the role of premature sarcopoenia, obesity and sedentary behaviour

Abstract

Premature declines in function among adults with cerebral palsy (CP) are generally attributed to weakness, spasticity and orthopaedic abnormalities, as well as chronic pain and fatigue. Very little research or clinical attention has been devoted to the confluence and consequences of early muscle wasting and obesity as mediators of secondary comorbidity in this population, and perhaps more importantly, to the role of lifestyle to potentiate these outcomes. At present, there are no national surveillance programmes that monitor chronic health in adults with CP; however, mortality records have demonstrated a greater prevalence of coronary heart disease as compared with the general population. Although by definition, CP is a 'non-progressive' condition, secondary factors such as habitual sedentary behaviour, obesity, and premature sarcoepenia may increase the severity of functional impairment throughout adulthood, and lead to cardiometabolic disease, fragility and/or early mortality. Herein we describe the heightened health risk represented in adults with CP, and discuss the hallmark phenotypic features that coincide with ageing, obesity and cardiometabolic disorders. Moreover, we provide discussion regarding the protective role of habitual physical activity to stimulate anti-inflammatory pathways and to ameliorate global risk. Although physical therapeutic modalities are already widely acknowledged as a vital component to improve movement quality in CP, the purpose of this review was to present a compelling case for the value of lifelong physical activity participation for both function and cardiometabolic health preservation.

Health service experiences to address mobility decline in ambulant adults ageing with cerebral palsy

“…However, evidence suggests that many adults with CP, having been ambulant as children, will experience loss of functional ability earlier than persons who are able bodied. A research priority within the CP community is to better understand and minimise secondary cardiometabolic and functional complications in adults, such as mobility deterioration, over time (Peterson, Gordon, & Hurvitz, 2013;Svien, Berg, & Stephenson, 2008). This direction is consistent with an emerging emphasis within the disability field to better understand the challenges facing individuals with disability as they age (Svien et al, 2008).…”

Mobility in Ambulant Adults with Cerebral Palsy — Challenges for the Future

“…Relative inactivity can result in further health related concerns such as premature sarcopenia and obesity (Peterson et al 2013). Furthermore, adults with CP may experience psychosocial issues, as well as secondary biomedical concerns, related to their disability (Horsman, Suto, Dudgeon and Harris 2010).…”

Asociaciones genéticas en la parálisis cerebral; un campo aún en estudio

“…Y quizás no muy lejos se logre entender la interacción entre la susceptibilidad genética tan heterogénea, con el entorno que involucra al niño aun antes de nacer 16,45,51 , es decir la relación de los hallazgos genéticos encontrados con los factores de riesgo neurológicos que involucran no solo prematurez, sino alimentación 52 , riesgo psicosocial16entre otros aspectos que no solo influyen en la presentación de la PC sino en las comorbilidades que afectan potencialmente el pronóstico y calidad de vida 53 , lo que parece ser la base de este complejo trastorno del neurodesarrollo llamado parálisis cerebral 20,49 .…”