Sleep and physical activity: the experiences of adults with cerebral palsy and recommendations for clinical practice
Prepared by: AACPDM Digest reviewer/ Mary Schmidt D.O.
Key words:
- Sleep
- Physical activity
- Cerebral palsy
Study type: Qualitative study
Summary: Interviews were conducted on fourteen adults with cerebral palsy (CP) focusing on factors related to sleep and physical activity (PA). Participants were recruited online through the Dutch patient association for individuals with CP. The participants’ ages ranged from 23 years to 59 years, all had verbal communication and all but one was ambulatory. Interview responses were coded and clustered into categories based on themes.
The balance of energy expenditure, rest, and activity involves a conscious effort to manage personal resources effectively throughout the day. This includes careful planning for activities, practicing energy conservation techniques, and establishing boundaries to prevent overexertion. The interaction between sleep and PA is highlighted as a crucial element of daily life, as these share a significant relationship that can be either beneficial or detrimental. Upon reaching adulthood, individuals with CP often experience a lack of adequate support and knowledge concerning the critical roles of sleep and PA and there is a desire for more comprehensive education by the healthcare system to better equip them with tools for self-management.
Participants reported a poor night's sleep had a negative impact on their mental state the following day. The more common physical complaints contributing to sleep disturbances were pain and spasms. Environmental factors such as cold temperatures, noise levels, and a busy living environment were also noted to disrupt sleep.
Participants reported both external and internal motivation for PA, and both sources were considered beneficial. Engaging in PA was found to have a positive impact on mental well-being. Regular physiotherapy visits were identified as a positive source of PA that improved function. Medical issues negatively impacted both motivation and the ability to participate in PA. Individuals with CP also reported that they required more recovery time after PA compared to peers. Several environmental factors limited PA, including challenges with transportation, the need for assistance, the cost associated with activities, and cold weather conditions.
Adults with CP struggle to manage and balance their energy resources, which becomes more challenging with age. Sleep, rest and activity are all interconnected and essential in maintaining balance in a 24-hour day.