Exercise Participation: Cerebral Palsy

When recommending exercise and sports participation for children with cerebral palsy, there are many factors to consider. Research is constantly being collected and analyzed on the benefits of physical activity for people with cerebral palsy. One topic is the use of muscle strengthening exercises. Some current research states that progressive resistance exercises has been shown to improve muscle strength and function. Some research has concluded that muscle strengthening does not increase muscle spasticity.

Regarding cardiovascular health, children with cerebral palsy:
1. have 2-3 times higher energy expenditure rates while walking
2. may have poor cardiovascular health
3. take many less steps per day than their typically developing peers

With these statistics in mind, aerobic exercise can be beneficial for children with cerebral palsy. Some examples of research studies indicating this are the following:
1. lower limb cycling (3x/week, 20 min sessions for 1.5 – 16 months) resulted in improved aerobic fitness
2. a community fitness program of aerobics, strength training, and stretching (3x/week for 10 weeks) resulted in increased muscle strength and improved perception of physical appearance
3. a systemic review of research indicated that short-term cardiorespiratory training (i.e. 2–4 months) increased aerobic fitness by 18–22% and long-term training (i.e. 8–9 months) by 26–41%. Short-term training (i.e. 2–4 months) increased activity by 0–13%, and long-term training (i.e. 8–9 months) by 2–9%. Aerobic activity provided little carry over into activity.

When deciding what sports or recreational activities are suitable for children with cerebral palsy, each child would have to be evaluated individually. Basically, once a child is thoroughly evaluated, a pediatric therapist can help to suggest recreational activities such as boccie ball, fishing, horseback riding and more. For formal sports such as swimming, wheelchair basketball, soccer or baseball, the therapist can help to suggest which sport would make a good fit for a particular child based on functional levels. In addition, any adaptations or modifications to the sports or recreational activity should be considered. 

References:
Darrah, Johanna PhD, PT; Wessel, Jean PhD, PT; Nearingburg, Patricia PhD, PE; O’Connor, Marjorie BEd, PE Evaluation of a Community Fitness Program for Adolescents with Cerebral Palsy Pediatric Physical Therapy Spring 1999 – Volume 11 – Issue 1
Butler, Jane M.; Scianni, Aline; Ada, Louise Effect of cardiorespiratory training on aerobic fitness and carryover to activity in children with cerebral palsy: a systematic review International Journal of Rehabilitation Research:
June 2010 – Volume 33 – Issue 2 – pp 97-103 doi: 10.1097/MRR.0b013e328331c555