High-intensity interval training to improve fitness in children with cerebral palsy

Abstract

AimTo evaluate effects of high-intensity interval training (HIT) on aerobic exercise capacity, quality of life, and body composition in children with cerebral palsy (CP).MethodsThis was a baseline control trial. Children with CP, Gross Motor Function Classification System (GMFCS) levels I–IV, and age 10–17 years were included. The primary outcome, peak, and submaximum oxygen uptake (VO2peak, VO2submax) were measured at enrolment to the study (T0), after a pretraining period (T1), and after HIT (T2). Secondary outcomes were quality of life assessed with the KINDL questionnaire, and body composition measured using whole body dual-energy X-ray absorptiometry scanning. The exercise was performed on treadmills and consisted of 24 sessions, each with a total of 16 min of exercise at >85% of maximal heart rate.Results20 children were included and 6 children dropped out. VO2peak increased by 10%, from a median of 37.3 (31.0–40.1) to 41.0 (36.6–48.5) mL/kg/min from T1 to T2 (p<0.01). VO2submax did not change; thereby, the percentage oxygen utilisation was reduced. Body composition was unchanged. Parent-reported quality of life improved, whereas quality of life reported by the children did not improve.ConclusionsAerobic exercise capacity improved and per cent utilisation of VO2max declined after HIT in children with CP. Therefore, HIT can be a time efficient way to improve maximal capacity, and increase energy reserve in this patient group.Trial registration numberNCT00965133.

Effect of Community-Based Functional Aerobic Training on Motor Performance and Quality of Life of Children with Spastic Cerebral Palsy

“…Following an eight-week case study to evaluate the effect of cardiovascular training on adult with athetoid CP, Teixeira et al, ( 41 ) observed a significant improvement in the QoL. The findings of this study substantiate positive outcomes of several studies where effects of aerobics training on the QoL of children with CP were investigated ( 2 , 5 , 14 , 35 , 41 ). Personal interest and opportunity to participate in activities is an important contributor to QoL.…”

“…In sedentary and/or inactive individuals, training result in significant improvement in exercise capacity in that, it elicits physical strain on the individual as a result of the increase in energy expenditure. The system then develops structural and functional adaptations to accommodate the change in expenditure which enables it to deliver more oxygen (O 2 ) and nutrients and to get rid of carbon dioxide (CO 2 ) and metabolic waste products thereby improving the efficiency of the cardiorespiratory system ( 14 , 15 ). Moreover, the functional nature of the training programme ensured that the force, torque and momentum generated by the muscles (calf, gluteus, knee extensor and flexor) are directly related to walking hence the positive results.…”

“…Lower exercise capacity and higher oxygen cost for activity are directly associated with children with CP ( 14 , 15 ). Aerobic exercise has been shown to reduce skin fold body fat, to improve peak oxygen consumption, ventilation and heart rate ( 16 ), to improve gross motor function and walking distance ( 17 ), aerobic capacity, quality of life and body composition ( 14 ) in children with CP.…”

Aquatic high intensity interval training to improve aerobic capacity is feasible in adolescents with cerebral palsy: pilot randomised controlled trial

“…The only comparable high intensity interval training study in adolescents with cerebral palsy was land based in which 30% did not complete the intervention. 23 Furthermore, comments from our study exit interviews were overwhelmingly positive regarding the intervention highlighting participants desire to continue this therapy approach, with statements encompassing all six of the ‘F words’ of disability, function, family, fitness, fun, friends and future. 24…”

The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair

“…We aimed to increase wheelchair propulsion time through improving three modifiable determinants of PA: wheelchair mobility skills (WMS), confidence in wheelchair mobility, and physical fitness [12][13][14]. Two studies in children with a disability [15,16] showed high-intensity interval training (HIIT) to have positive results on physical fitness. High intensity interval training consists of intermittent bouts of activity and rest, which is similar to the active behaviour of youth [17].…”