European Journal of Adapted Physical Activity 14, 12 (2021) | DOI: 10.5507/euj.2021.003
A community-based exercise program for ambulant adolescents with cerebral palsy, a feasibility study
- 1 Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
- 2 Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, EH21 6UU, UK
- 3 NHS Lothian, Edinburgh, UK
The aim of this study was to investigate the feasibility of an 18-week exercise program for adolescents with cerebral palsy (CP). Fourteen individuals aged 16-25 (GMFCS I-III) performed aerobic and strength exercises at their community leisure center up to three times a week. A physiotherapist provided instruction at the first session and between 2-4 times thereafter. The fitness instructor on duty provided supervision when required. Feasibility of the exercise program was explored through an exercise logbook and participant feedback questionnaire. Gross motor function, muscle strength, aerobic capacity and the Timed Up and Go test were assessed at baseline, 6, 12 and 18 weeks. Quality of life and self-esteem were measured at baseline and 12 and 18 weeks. Participants completed a mean 14.8 (range 5-23) weeks of the exercise program and a mean of 31 (range 10-52) sessions. The results of the feedback questionnaire suggested that the exercise program was mostly well accepted. Adverse effects (muscle soreness and fatigue) were reported by three participants. Results indicated the feasibility of a community exercise program for adolescents with CP and recommendations for sustainable exercise programs for this group were provided.
Keywords: Physical Function, Gross Motor, Mental Health, Quality of Life, Intervention
Received: November 22, 2019; Revised: February 9, 2021; Accepted: March 21, 2021; Prepublished online: March 21, 2021; Published: November 22, 2021 Show citation
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References
- American College of Sports Medicine. (2013). ACSM's resource manual for guidelines for exercise testing and prescription (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins
- Benner, J.L., Hilberink, S.R., Veenis, T., Stam, H.J., van der Slot, W.M., & Roebroeck. M.E. (2017). Long-term deterioration of perceived health and functioning in adults with cerebral palsy. Archives of Physical Medicine and Rehabilitation, 98(11), 2196-2205. https://doi.org/10.1016/j.apmr.2017.03.013
Go to original source...
Go to PubMed...
- Biddle, S. J., Fox, K., & Boutcher, S. (2003). Physical activity and psychological well-being. Abingdon, Oxon: Routledge.
Go to original source...
- Blackman, J.A., & Conaway, M.R. (2014). Adolescents with cerebral palsy: transitioning to adult health care services. Clinical Pediatrics, 53(4), 356-63. https://doi.org/10.1177/0009922813510203
Go to original source...
Go to PubMed...
- Bloemen, M. A., Backx, F. J., Takken, T., Wittink, H., Benner, J., Mollema, J., & de Groot, J. F. (2015). Factors associated with physical activity in children and adolescents with a physical disability: a systematic review. Developmental Medicine & Child Neurology, 57(2), 137-148. https://doi.org/10.1111/dmcn.12624
Go to original source...
Go to PubMed...
- Bonnefoy-Mazure, A., De Coulon, G., & Armand, S. (2020). Self-perceived gait quality in young adults with cerebral palsy. Developmental Medicine & Child Neurology, 62(7), 868-873. https://doi.org/10.1111/dmcn.14504
Go to original source...
Go to PubMed...
- Borg G. (1998). Borg's perceived exertion and pain scales. Champaign, IL: Human kinetics.
- Bottos, M., Feliciangeli, A., Sciuto, L., Gericke, C., &Vianello, A. (2001). Functional status of adults with cerebral palsy and implications for treatment of children. Developmental Medicine & Child Neurology, 43(8), 516-528. https://doi.org/10.1017/s0012162201000950
Go to original source...
Go to PubMed...
- Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., Bakken, S., Kaplan, C. P., Squiers, L., Fabrizio, C., & Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452-457. https://doi.org/10.1016/j.amepre.2009.02.002
Go to original source...
Go to PubMed...
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York, NY: Lawrence Erlbaum Associates
- Darmawan, I., Bakker, C., Brockman, T. A., Patten, C. A., & Eder, M. (2020). The role of social media in enhancing clinical trial recruitment: scoping review. Journal of Medical Internet Research, 22(10), e22810. https://doi.org/10.2196/22810
Go to original source...
Go to PubMed...
- Diener, E. (1994). Assessing subjective well-being: Progress and opportunities. Social Indicators Research, 31(2), 103-157. https://doi.org/10.1007/bf01207052
Go to original source...
- Dodd, K. J., Taylor, N. F., & Graham, H. K. (2003). A randomized clinical trial of strength training in young people with cerebral palsy. Developmental Medicine & Child Neurology, 45(10), 652-657. https://doi.org/10.1017/s0012162203001221
Go to original source...
Go to PubMed...
- Durstine, J. L., Painter, P., Franklin, B. A., Morgan, D., Pitetti, K. H., & Roberts, S. O. (2000). Physical activity for the chronically ill and disabled. Sports Medicine, 30(3), 207-219. https://doi.org/10.2165/00007256-200030030-00005
Go to original source...
Go to PubMed...
- El-Kotob, R., & Giangregorio, L. M. (2018). Pilot and feasibility studies in exercise, physical activity, or rehabilitation research. Pilot and Feasibility Studies, 4, 137. https://doi.org/10.1186/s40814-018-0326-0
Go to original source...
Go to PubMed...
- Erdfelder, E., Faul, F., & Buchner, A. (1996). GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers, 28(1), 1-11.
Go to original source...
- Espín-Tello, S. M., Dickinson, H. O., Bueno-Lozano, M., Jiménez-Bernadó, M. T., & Caballero-Navarro, A. L. (2018). Functional capacity and self-esteem of people with cerebral palsy. American Journal of Occupational Therapy, 72(3), 1-8. https://doi.org/10.5014/ajot.2018.025940
Go to original source...
Go to PubMed...
- Hjalmarsson, E., Fernandez-Gonzalo, R., Lidbeck, C., Palmcrantz, A., Jia, A., Kvist, O., Pontén, E., & von Walden, F. (2020). RaceRunning training improves stamina and promotes skeletal muscle hypertrophy in young individuals with cerebral palsy. BMC Musculoskeletal Disorders, 21(1), 193. https://doi.org/10.1186/s12891-020-03202-8
Go to original source...
Go to PubMed...
- Jacobson, D. N., Löwing, K., & Tedroff, K. (2020). Health-related quality of life, pain, and fatigue in young adults with cerebral palsy. Developmental Medicine & Child Neurology, 62(3), 372-378. https://doi.org/10.1111/dmcn.14413
Go to original source...
Go to PubMed...
- Julious, S. A. (2005). Sample size of 12 per group rule of thumb for a pilot study. Pharmaceutical Statistics, 4(4), 287-291. https://doi.org/10.1002/pst.185
Go to original source...
- Kiapekos, N., Broström, E., Hägglund, G., & Åstrand, P. (2019). Primary surgery to prevent hip dislocation in children with cerebral palsy in Sweden: a minimum 5-year follow-up by the national surveillance program (CPUP). Acta Orthopaedica, 90(5), 495-500.https://doi.org/10.1080/17453674.2019.1627116
Go to original source...
Go to PubMed...
- Lai, B., Lee, E., Wagatsuma, M., Frey, G., Stanish, H., Jung, T., & Rimmer, J. H. (2020). Research trends and recommendations for physical activity interventions among children and youth with disabilities: A review of reviews. Adapted Physical Activity Quarterly, 37(2), 211-234. https://doi.org/10.1123/apaq.2019-0081
Go to original source...
Go to PubMed...
- Lauruschkus, K., Westbom, L., Hallström, I., Wagner, P., & Nordmark, E. (2013). Physical activity in a total population of children and adolescents with cerebral palsy. Research in Developmental Disabilities, 34(1), 157-167. https://doi.org/10.1016/j.ridd.2012.07.005
Go to original source...
Go to PubMed...
- Liljenquist, K., O'Neil, M. E., & Bjornson, K. F. (2018). Utilization of physiotherapy services during transition for young people with cerebral palsy: a call for improved care into adulthood. Physiotherapy, 98(9), 796-803. https://doi.org/10.1093/ptj/pzy068
Go to original source...
Go to PubMed...
- Majnemer, A., Shikako-Thomas, K., Lach, L., Shevell, M., Law, M., Schmitz, N., Poulin, C., & QUALA Group (2014). Rehabilitation service utilization in children and youth with cerebral palsy. Child: Care, Health and Development, 40(2), 275-282. https://doi.org/10.1111/cch.12026
Go to original source...
Go to PubMed...
- McMullen, T., & Resnick, B. (2013). Self-esteem among nursing assistants: reliability and validity of the Rosenberg Self-Esteem Scale. Journal of Nursing Measurement, 21(2), 335-344. https://doi.org/10.1891/1061-3749.21.2.335
Go to original source...
Go to PubMed...
- Noble, P. C., Conditt, M. A., Cook, K. F., & Mathis, K. B. (2006). The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clinical Orthopaedics and Related Research, 452, 35-43. https://doi.org/10.1097/01.blo.0000238825.63648.1e
Go to original source...
Go to PubMed...
- Opheim, A., McGinley, J., Olsson, E., Stanghelle, J., & Jahnsen, R. (2013). Walking deterioration and gait analysis in adults with spastic bilateral cerebral palsy. Gait & Posture, 37(2), 165-171. https://doi.org/10.1016/j.gaitpost.2012.06.032
Go to original source...
Go to PubMed...
- Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology, 39(4), 214-223. https://doi.org/10.1111/j.1469-8749.1997.tb07414
Go to original source...
Go to PubMed...
- Plante, T.G., Lantis, A. & Checa, G. (1998). The influence of perceived versus aerobic fitness on psychological health and physiological stress responsivity. International Journal of Stress Management 5, 141-156 https://doi.org/10.1023/A:1022936930992
Go to original source...
- Rimmer, J. H., Riley, B., Wang, E., Rauworth, A., & Jurkowski, J. (2004). Physical activity participation among persons with disabilities: barriers and facilitators. American Journal of Preventive Medicine, 26(5), 419-425. https://doi.org/10.1016/j.amepre.2004.02.002
Go to original source...
Go to PubMed...
- Rimmer, J. H., Chen, M. D., & Hsieh, K. (2011). A conceptual model for identifying, preventing, and managing secondary conditions in people with disabilities. Physical Therapy, 91(12), 1728-1739. https://doi.org/10.2522/ptj.20100410
Go to original source...
Go to PubMed...
- Russell, D. J., Rosenbaum, P. L., Wright, M., Avery, L. M. (2002). Gross motor function measure (GMFM-66 & GMFM-88) user's manual. London: Mac Keith Press.
- Ryan, J. M., Cassidy, E. E., Noorduyn, S. G., & O'Connell, N. E. (2017). Exercise interventions for cerebral palsy. Cochrane Database Systematic Review, 6(6). https://doi.org/10.1002/14651858.CD011660.pub2
Go to original source...
Go to PubMed...
- Ryan, J. M., Lavelle, G., Theis, N., Noorkoiv, M., Kilbride, C., Korff, T., Baltzopoulos, V., Shortland, A., Levin, W., & Star Trial Team (2020). Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial. Developmental Medicine & Child Neurology, 62(11), 1283-1293. https://doi.org/10.1111/dmcn.14601
Go to original source...
Go to PubMed...
- Seniorou, M., Thompson, N., Harrington, M., Stebbins, J., & Theologis, T. (2002). Reliability of strength measurements in healthy children and children with cerebral palsy using a digital myometer Gait & Posture, 16(Suppl 1), 175-6. https://doi.org/10.1016/S0966-6362(02)00097-8
Go to original source...
- Shields, N., van den Bos, R., Buhlert-Smith, K., Prendergast, L., Taylor, N. (2019). A community-based exercise program to increase participation in physical activities among youth with disability: a feasibility study. Disability and Rehabilitation, 41(10), 1152-1159. https://doi.org/10.1080/09638288.2017.1422034
Go to original source...
Go to PubMed...
- Sienko, S. (2019). Understanding the factors that impact the participation in physical activity and recreation in young adults with cerebral palsy (CP). Disability and Health Journal, 12(3), 467-472. https://doi.org/10.1016/j.dhjo.2019.02.008
Go to original source...
Go to PubMed...
- Skelton, J.A., & Beech, B.M. (2011). Attrition in paediatric weight management: a review of the literature and new directions. Obesity Review, 12(5), e273-e281. https://doi.org/10.1111/j.1467-789x.2010.00803.x
Go to original source...
Go to PubMed...
- Slaman, J., van den Berg-Emons, H. J. G., van Meeteren, J., Twisk, J., van Markus, F., Stam, H. J., van der Slot, W.M., & Roebroeck, M. E. (2015a). A lifestyle intervention improves fatigue, mental health and social support among adolescents and young adults with cerebral palsy: Focus on mediating effects. Clinical Rehabilitation, 29(7), 717-727. https://doi.org/10.1177/0269215514555136
Go to original source...
Go to PubMed...
- Slaman, J., Roebroeck, M., Dallmeijer, A., Twisk, J., Stam, H., van den Berg-Emons, R., & Learn 2 Move Research Group. (2015b). Can a lifestyle intervention program improve physical behaviour among adolescents and young adults with spastic cerebral palsy? A randomized controlled trial. Developmental Medicine & Child Neurology, 57(2), 159-166. https://doi.org/10.1111/dmcn.12602
Go to original source...
Go to PubMed...
- Tappe, M. K., Duda, J. L., & Ehrnwald, P. M. (1989). Perceived barriers to exercise among adolescents. The Journal of School Health, 59(4), 153-155. https://doi.org/10.1111/j.1746-1561.1989.tb04689.x
Go to original source...
Go to PubMed...
- Taylor, N.F., Dodd, K.J., Baker, R.J., Willoughby, K., Thomason, P., & Graham, H.K. (2013). Progressive resistance training and mobility-related function in young people with cerebral palsy: a randomized controlled trial. Developmental Medicine & Child Neurology, 55(9), 806-12. https://doi.org/10.1111/dmcn.12190
Go to original source...
Go to PubMed...
- Tickle-Degnen, L. (2013). Nuts and bolts of conducting feasibility studies. American Journal of Occupational Therapy, 67(2), 171-176. http://doi.org/10.5014/ajot.2013.006270
Go to original source...
Go to PubMed...
- Verschuren, O., Takken, T., Ketelaar, M., Gorter, J.W., & Helders, P.J. (2006). Reliability and validity of data for 2 newly developed shuttle run tests in children with cerebral palsy. Physical Therapy, 86(8), 1107-17. https://doi.org/10.1093/ptj/86.8.1107
Go to original source...
- Verschuren, O., Ketelaar, M., Gorter, J. W., Helders, P. J., Uiterwaal, C. S., & Takken, T. (2007). Exercise training program in children and adolescents with cerebral palsy: a randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 161(11), 1075-1081. https://doi.org/10.1001/archpedi.161.4.356
Go to original source...
Go to PubMed...
- Verschuren, O., Peterson, M. D., Balemans, A. C., & Hurvitz, E. A. (2016). Exercise and physical activity recommendations for people with cerebral palsy. Developmental Medicine & Child Neurology, 58(8), 798-808. https://doi.org/10.1111/dmcn.13053
Go to original source...
Go to PubMed...
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