Abstract
Objective
To evaluate both the short- and long-term effectiveness of a lifestyle intervention
on physical fitness in adolescents and young adults with cerebral palsy (CP).
Design
Single-blind, randomized controlled trial.
Setting
University hospitals and rehabilitation clinics.
Participants
Adolescents and young adults (N=57) with spastic CP classified in Gross Motor Function
Classification System levels I through IV; of these, 42 completed the study.
Intervention
A 6-month lifestyle intervention consisting of physical fitness training combined
with counseling sessions focused on physical behavior and sports participation.
Main Outcome Measures
Physical fitness, including measures of cardiopulmonary fitness, muscle strength,
and body composition.
Results
Favorable short- and medium-term effects were found for peak oxygen consumption, oxygen
consumption, and load on the anaerobic threshold and waist circumference. Favorable
long-term effects were found for sum of skinfolds, systolic blood pressure, and total
cholesterol.
Conclusions
This exploratory study showed that the lifestyle intervention was effective in improving
cardiopulmonary fitness and body composition. Effects of body composition were maintained
in the long term. However, the intervention needs to be optimized to increase muscle
strength and for long-term retention of effects on aerobic capacity.
Keywords
List of abbreviations:
AT ( anaerobic threshold), CP ( cerebral palsy), CPET ( cardiopulmonary exercise testing), GEE ( generalized estimating equation), GMFCS ( Gross Motor Function Classification System), PA ( physical activity), Vo2peak ( peak oxygen consumption)To read this article in full you will need to make a payment
Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Is physical activity or physical fitness more important in defining health benefits?.Med Sci Sports Exerc. 2001; 33 (discussion S419-20): S379-S399
- Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women.JAMA. 1996; 276: 205-210
- A report: the definition and classification of cerebral palsy April 2006.Dev Med Child Neurol Suppl. 2007; 109: 8-14
- Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions.Phys Ther. 1999; 79: 495-502
- Exercise in the prevention of chronic disabling illness.Human Kinetics, Champaign1999
- Physical strain of walking relates to activity level in adults with cerebral palsy.Arch Phys Med Rehabil. 2013; 94: 896-901
- Impact of cerebral palsy on health-related physical fitness in adults: systematic review.Arch Phys Med Rehabil. 2012; 93: 871-881
- Physical fitness, everyday physical activity, and fatigue in ambulatory adults with bilateral spastic cerebral palsy.Scand J Med Sci Sports. 2011; 21: 535-542
- Maximal aerobic and anaerobic exercise responses in children with cerebral palsy.Med Sci Sports Exerc. 2013; 45: 561-568
- Inactive lifestyle in adults with bilateral spastic cerebral palsy.J Rehabil Med. 2009; 41: 375-381
- Daily physical activity of schoolchildren with spastic diplegia and of healthy control subjects.J Pediatr. 1995; 127: 578-584
- Physical activity level and related factors in adolescents with cerebral palsy.Pediatr Exerc Sci. 2008; 20: 95-106
- Ambulatory physical activity performance in youth with cerebral palsy and youth who are developing typically.Phys Ther. 2007; 87: 248-257
- Childhood participation in organized school sports and physical education as precursors of adult physical activity.Am J Prev Med. 1987; 3: 276-281
- Physical activity from childhood to adulthood: a 21-year tracking study.Am J Prev Med. 2005; 28: 267-273
- Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.Public Health Rep. 1985; 100: 126-131
- Exercise programs for children with cerebral palsy: a systematic review of the literature.Am J Phys Med Rehabil. 2008; 87: 404-417
- A systematic review of the effectiveness of aerobic exercise interventions for children with cerebral palsy: an AACPDM evidence report.Dev Med Child Neurol. 2008; 50: 808-814
- Successfully improving physical activity behavior after rehabilitation.Am J Health Promot. 2007; 21: 153-159
- The efficacy of an implementation intention intervention for promoting physical activity among individuals with spinal cord injury: a randomized controlled trial.Rehabil Psychol. 2006; 51: 273-280
- Promoting physical activity in an adolescent and a young adult with physical disabilities.Disabil Health J. 2009; 3: 86-92
- Learn 2 Move 16-24: effectiveness of an intervention to stimulate physical activity and improve physical fitness of adolescents and young adults with spastic cerebral palsy; a randomized controlled trial.BMC Pediatr. 2010; 10: 79
- Content validity of the expanded and revised Gross Motor Function Classification System.Dev Med Child Neurol. 2008; 50: 744-750
- Physical activity and exercise in children with chronic health conditions.J Sport Health Sci. 2012; 2: 12-20
- Measuring daily behavior using ambulatory accelerometry: the Activity Monitor.Behav Res Methods Instrum Comput. 2001; 33: 349-356
- What is motivational interviewing?.Behav Cogn Psychother. 1995; 23: 325-334
- American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.Med Sci Sports Exerc. 2011; 43: 1334-1359
- Maximal aerobic power in cerebral palsied wheelchair athletes: validity and reliability.Arch Phys Med Rehabil. 1992; 73: 246-252
- Determination of anaerobic threshold by the ventilation equivalent in normal individuals.Respiration. 1979; 38: 36-42
- The 220-age equation does not predict maximum heart rate in children and adolescents.Dev Med Child Neurol. 2011; 53: 861-864
- ACSM’s guidelines for exercise testing and prescription.8th ed. Lippincott Williams & Wilkins, Philadelphia2010
- A comparison of make and break tests using a hand-held dynamometer and the Kin-Com.J Orthop Sports Phys Ther. 1994; 19: 28-32
- Applied longitudinal data analysis for epidemiology; a practical guide.Cambridge Univ Pr, Cambridge2003
- Normal standards for an incremental progressive cycle ergometer test.Am Rev Respir Dis. 1985; 131: 700-708
- Longitudinal study of physical working capacity of young people with spastic cerebral palsy.Dev Med Child Neurol. 1984; 26: 328-334
- Maximal aerobic capacity of young people with spastic cerebral palsy.Dev Med Child Neurol. 1978; 20: 205-210
- Oxygen consumption in relation to work load in students with cerebral palsy.J Appl Physiol. 1976; 40: 873-875
- Long-term effectiveness of interventions promoting physical activity: a systematic review.Prev Med. 2008; 47: 354-368
- Effect of cardiorespiratory training on aerobic fitness and carryover to activity in children with cerebral palsy: a systematic review.Int J Rehabil Res. 2010; 33: 97-103
- Cardiovascular disease risk in adults with spastic bilateral cerebral palsy.J Rehabil Med. 2013; 45: 866-872
RIVM. NL de Maat. 2012. Available at: http://www.rivm.nl/Bibliotheek/Wetenschappelijk/Tabellen_grafieken/Preventie_Ziekte_Zorg/NL_de_Maat. Accessed January 26, 2012.
- Muscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review.Aust J Physiother. 2009; 55: 81-87
- Muscle strengthening in children and adolescents with spastic cerebral palsy: considerations for future resistance training protocols.Phys Ther. 2011; 91: 1130-1139
- Validity of COSMED's quark CPET mixing chamber system in evaluating energy metabolism during aerobic exercise in healthy male adults.Res Sports Med. 2013; 21: 136-145
- Validation of a computerized metabolic measurement system (Oxycon-Pro) during low and high intensity exercise.Int J Sports Med. 2001; 22: 291-294
- Blood cholesterol screening influence of fasting state on cholesterol results and management decisions.J Gen Intern Med. 2000; 15: 395-399
- Comparison of fasting and postprandial plasma lipoproteins in subjects with and without coronary heart disease.Am J Cardiol. 2001; 88: 1129-1133
- The relationship between nonfasting and fasting lipid measurements in patients with or without type 2 diabetes mellitus receiving treatment with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors.Clin Ther. 2003; 25: 1490-1497
- Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III).JAMA. 2001; 285: 2486-2497
Article Info
Publication History
Published online: June 02, 2014
Footnotes
Supported by Netherlands Organisation for Health Research and Development (grant no. 89000002 ) and Phelps Stichting (grant no. 2008039 ).
This project is part of the Dutch LEARN 2 MOVE research program.
Clinical Trial Registration No.: NTR1785.
Disclosures: none.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
