A1 Journal article (refereed)
Effects of multicomponent exercise intervention on cardiometabolic risk factors in children and young adults with cerebral palsy : a multiple-baseline trial (2024)

Savikangas, T., Valadão, P., Haapala, E. A., & Finni, T. (2024). Effects of multicomponent exercise intervention on cardiometabolic risk factors in children and young adults with cerebral palsy : a multiple-baseline trial. BMC Sports Science, Medicine and Rehabilitation, 16, Article 219. https://doi.org/10.1186/s13102-024-01006-0

JYU authors or editors

Savikangas, Tiina
Frederico Valadao, Pedro
Haapala, Eero
Juutinen, Taija

Publication details

All authors or editors: Savikangas, Tiina; Valadão, Pedro; Haapala, Eero A.; Finni, Taija

Journal or series: BMC Sports Science, Medicine and Rehabilitation

eISSN: 2052-1847

Publication year: 2024

Publication date: 21/10/2024

Volume: 16

Article number: 219

Publisher: BioMed Central

Publication country: United Kingdom

Publication language: English

DOI: https://doi.org/10.1186/s13102-024-01006-0

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/97664

Abstract

Background
Adults with cerebral palsy (CP) have a high risk of cardiometabolic diseases. It is unknown whether this risk is elevated in young people with CP and whether exercise can reduce this risk. Therefore, we investigated the effects of the EXErcise for Cerebral Palsy (EXECP) intervention on cardiometabolic risk in children and young adults with CP and compared this risk to typically developing children and young adults (TDs).

Methods
Ambulatory male and female participants with spastic CP, aged 9–24 years, and age- and sex-matched TDs without musculoskeletal disorders were recruited. Participants with CP were measured at baseline, after a three-month control period manifesting normal development, and after the three-month strength, gait, and flexibility training intervention. TDs were measured at baseline and after the control period. They did not attend the intervention. Cardiometabolic risk factors included body weight, body fat percentage, and skeletal muscle mass index assessed with bioimpedance; resting systolic and diastolic blood pressure and aortic pulse wave velocity assessed with a non-invasive oscillometric device; fasting plasma high-density and low-density lipoprotein cholesterol, triglyceride, and glucose levels. Data were analyzed with independent samples t-tests and linear mixed-effects models adjusted for sex and age.

Results
The study involved 18 participants with CP (13 males, 9–22 year, mean 14.2 ± 4.4) and 17 TDs (12 males, 9–22 year, mean 14.6 ± 4.3). At baseline, participants with CP had a 1.0 (95% confidence interval (CI) [-2.0, -0.0]) kg/m2 lower skeletal muscle mass index than TDs. During the control period, no statistically significant between-group differences were observed in the change of any outcome. In the CP group, body weight (β = 1.87, 95% CI [1.04, 2.70]), fat percentage (β = 1.22 [0.07, 2.37], and blood glucose (β = 0.19, 95% CI [0.01, 0.37]) increased, while diastolic blood pressure (β=-2.31, 95% CI [-4.55, -0.06]) and pulse wave velocity (β=-0.44, 95% CI [-0.73, -0.16]) decreased. In the TD group, only body weight increased (β = 0.85, 95% CI [0.01, 1.68]) statistically significantly. In the CP group, no changes were observed during the intervention.

Conclusions
Young people with and without CP do not exhibit significant differences in most cardiometabolic risk factors. EXECP intervention may attenuate some adverse development trajectories occurring without the intervention but greater volume and intensity of aerobic exercise may be needed to reduce cardiometabolic risk.

Keywords: cerebral palsy; cardiovascular diseases; training; strength training; lipids; body composition; blood pressure; glucose