Physical activity and exercise interventions in adults with cerebral palsy: a systematic review of quantitative and qualitative studies
Prepared by: AACPDM Digest reviewer/Kathleen M. Friel, Ph.D.
Citation: Andreopoulou G., Meharry J. B., Jagadamma K. C., & van der Linden M. L. (2024). Physical activity and exercise interventions in adults with cerebral palsy: a systematic review of quantitative and qualitative studies. Disabil Rehabil Aug 24:1-15. doi: 10.1080/09638288.2024.2391568.
Keywords:
- Physical activity
- Exercise
- Adults
Study Type: Systematic review.
Summary: Regular exercise is important for cardiovascular, bone, and muscle health. In adults with cerebral palsy (CP), exercise also holds potential for reducing the occurrence and severity of secondary health challenges, including reduction in mobility. This systematic review assessed the existing quantitative and qualitative evidence related to the physical and psychosocial effects of exercise in adults with CP.
The study team searched nine online publishing databases to find articles that met the following criteria: age of participants an average of 18years or older, report of a physical activity or exercise intervention aimed at improving health or fitness, and were a randomized or pseudo-randomized study design with pre-post assessments. Studies that queried adults with CP about exercise experience and views were also included.
A total of 22 full text studies were included in this review. Among them, 10 articles reported on resistance training, while four reported on aerobic training that included a walking component. Three studies used mixed exercise interventions, four studied dance-based exercise, and one investigated sports participation. Only two of these studies included non-ambulatory adults. A meta-analysis of studies with comparable data (n=9) demonstrated an improvement in leg strength, but no changes in walking speed or endurance. However, the improvement in leg strength was considered very low confidence evidence, due to variability between studies, potential bias, and small sample sizes.
Importantly, the systematic review provided insights into supporting the sustainability of exercise programs in people’s lives. Group-based exercise, understanding the perceived benefits of exercise, and maintaining realistic expectations were identified as key factors contributing to a sustainable exercise regimen in adults with CP.