Promotion of Physical Fitness and Prevention of Secondary Conditions for Children With Cerebral Palsy: Section on Pediatrics Research Summit Proceedings

Abstract

Inadequate physical fitness is a major problem affecting the function and health of children with cerebral palsy (CP). Lack of optimal physical activity may contribute to the development of secondary conditions associated with CP such as chronic pain, fatigue, and osteoporosis. The purpose of this article is to highlight the content and recommendations of a Pediatrics Research Summit developed to foster collaborative research in this area. Two components of physical fitness-muscle strength and cardiorespiratory fitness-were emphasized. Although there is evidence to support the use of physical fitness interventions, there are many gaps in our current knowledge. Additional research of higher quality and rigor is needed in order to make definitive recommendations regarding the mode, intensity, frequency, and duration of exercise. Outcome measurements have focused on the body functions and structures level of the International Classification of Functioning, Disability and Health (ICF), and much less is known about effects at the activities and participation levels. Additionally, the influence of nutritional and growth factors on physical fitness has not been studied in this population, in which poor growth and skeletal fragility have been identified as serious health issues. Current intervention protocols and outcome measurements were critically evaluated, and recommendations were made for future research.

Physiotherapeutic interventions and physical activity for children in Northern Sweden with cerebral palsy: a register study from equity and gender perspectives

“…As such they are one important basis for habilitation interventions because they are crucial for participation in daily life and society [24,25]. Physical activity in leisure time, as well as physical education in school, is crucial to enhance function and maintain health [26,27].…”

“…Their study, based on CPUP data, show no significant differences between boys and girls with regard to physiotherapy interventions, but the type of intervention and presence of the PT was not specified. For children with CP, access to physiotherapy and physical activity is a crucial prerequisite for good health and function, as well as participation in society [25,40]. …”

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“…An alternative method to improve muscle strength is the electrical stimulation. This method may be more attractive because it provokes muscle contractions without any voluntary control (Fowler et al, 2007). However, Kerr and colleagues (2004) did not find conclusive evidence regarding the effectiveness of this method in people with CP.…”

“…People with CP may have problems when executing movements because their muscular activation is deteriorated (Fowler et al, 2007). Consequently, their lower muscle activation may limit their ability to exercise in the adequate intensity and reduce the cardiorespiratory adaptations that normally accompany exercise (Fowler et al, 2007).…”

“…A low level of fitness in people with CP contributes to the development of chronic pain, fatigue and osteoporosis (Fowler et al, 2007). People with CP need to exercise regularly in order to maintain their muscle length and strength (Tardieu, Tardieu, Colbeau-Justin, & Lespargot, 1982).…”