sports, exercise, cerebral palsy

benefits of evidence-based physical activity for people with cerebral palsy

Physical activity has proven to be more important for people with disabilities, including cerebral palsy, than people without disabilities. People with cerebral palsy are 1.5 times more likely to experience cardiovascular disease-related conditions such as diabetes, hypercholesterolemia, hypertension, and stroke. Some will even experience metabolic syndrome by the time they reach middle-adulthood. These conditions are believed to be caused by the lack of regular moderate-intensity exercise behavior. Strong evidence suggests that exercise can relieve pain and fatigue, which are two secondary conditions among cerebral palsy. Exercise may also improve spasticity, range of motion, and mobility. So, it is particularly important for people with physical disabilities to get moving on a regular basis to live long, healthy lives. Exercise isn’t just for improving health, but for maintaining health as well. 

Physical Activities that Benefit People with Cerebral Palsy

There are many kinds of physical activities that people with cerebral palsy can participate in – for both ambulatory people as well those who use various mobility devices.

1. Regular participation in physical activity by people with cerebral palsy over a period of 1-2 months can improve the following:

• musculoskeletal strength
• cardiorespiratory fitness or endurance
• quality of life
• spasticity
• general physical function, including functional mobility and walking performance

2. Types of physical activity with evidence to support their benefits include:

• Strength training
• Aerobic training (e.g., walking or cycling)
• Active video games
• A variety of adaptive sports and recreation, as well as leisure activities

3. Behavioral coaching can enhance the likelihood of engaging people with cerebral in physical activity.

• Behavioral coaching can include strategies to change behavior, such as promoting high self-confidence, goal setting, and planning

4. Telehealth programs of physical activity are safe, beneficial, and accessible. 

For example, a study suggested that web-based training with a virtual coach through videoconference could improve activity capacity, functional strength, and walking endurance. Another study demonstrated that phone call coaching plus web-based support could improve body weight in a group of people that included cerebral palsy. These are very convenient programs since they do not require transportation to a fitness facility.

5. There were essentially no studies that demonstrated that exercise was unsafe for people with cerebral palsy.  Exercise and physical activity is for everyone!

tips for families and individuals with cerebral palsy

• For adults, do your best to try and reach 150 minutes per week of moderate-to-vigorous intensity physical activity. For children, help your child try and reach 60 minutes per day of moderate-to-vigorous intensity physical activity. These are the same guidelines set for the general population to receive health benefits. Weight loss might require a higher volume of exercise. Do note that these guidelines, particularly the 60 minutes per day for children, might not always be possible. Do not be discouraged by this, just remember that SOME IS ALWAYS BETTER THAN NONE. 
• Cerebral palsy specific guidelines for aerobic endurance training: A review study noted that: “According to the existing intervention studies, [aerobic] exercise prescription for people with CP should include:  a minimum frequency of 2–3 times per week; an intensity between 60–95% of peak heart rate, or between 40–80% of the HRR, or between 50–65% of VO_2peak; and a minimum time of 20 minutes per session, for at least 8 consecutive weeks, when training three times a week, or for 16 consecutive weeks when training two times a week. Moreover, a pre-workout warm-up and cool-down could be added to reduce musculoskeletal injury.”
• Cerebral palsy specific guidelines for strength training: There were also reports that “prescription of resistance exercise for persons with CP should include a ‘familiarization’ period, in which very low dosage training (i.e. minimal volume and intensity) occurs twice a week for at least 2–4 weeks.” After the familiarization phase of training, it may be expected that individuals with CP could safely benefit from gradual increases in dosage to accommodate improvements in strength, endurance, and function. Complex, multi-joint activities (like step-ups and sit-to-stand exercises) could also be added at this time. We recommend performing 1–4 sets of 6–15 repetitions, and gradually progress to meet the demands of improved muscular fitness. It is also important that the programs last sufficiently long to incorporate these two phases of training. Assuming a minimum of 8 weeks to experience changes in strength with simple activities, we would suggest a program of at least 12–16 weeks in order to maximize the likelihood of a training effect in people with CP.”
• When in doubt of whether an exercise is safe or appropriate, contact a trained exercise instructor who has experience working with people with physical disabilities. Another option is to look for adaptive sports and recreation programs in your local community. Lions United Fitness Center is a good source for these programs.
• Many of the benefits that are obtained from exercise may not be easily observable or noticeable right away. Know that exercise is important for prevention as well as improvement and has many other benefits, such as improving psychological (e.g., depression, self-confidence) and social (e.g., building friendships with peers and trainers) health across the lifespan and for people of all ability levels.

exercise and physical activity ideas for people with cerebral palsy

• Strength Training
• Active Video Gaming
• Cycling
• Adaptive CrossFit
• Yoga
• Dance
• Walking/Running
• Frame Running (Race Running)
• Swimming
• Horseback riding
• Adaptive Rock climbing
• Archery
• Adaptive Skiing

If you are parent or caregiver of a child with cerebral palsy, encourage your child to participate in whatever sport or activity they’re interested in. Chances are, there’s an adaptive version of it.

Cerebral palsy can definitely make participating in some physical activities more difficult. However, with Coach Andy, you will have the resources and support needed, so you or your child can learn how to safely participate and live a more active lifestyle.