Maximal Aerobic Capacity of Young People with Spastic Cerebral Palsy

Abstract

SUMMARY Maximal aerobic capacity in bicycle ergometer tests was studied in nine children (aged 11 to 12 years) and five young men (aged 19 to 23 years), all with a spastic form of cerebral palsy, and compared with non‐handicapped control groups. Results showed somewhat lower values for heart rate, oxygen uptake/kg, ventilation/kg and blood lactate concentrations for the majority of the spastic group. The physical work capacity of the handicapped group amounted to about 50 per cent of the corresponding values for the non‐handicapped controls. Poor mechanical efficiency in the spastic group is the consequence of high oxygen uptake in relation to the work performed. The poor mechanical performance is mainly caused by the extra amount of energy required for qualitative changes in the muscle (constant hypertonia), involuntary movements and stabilizing movements during exercise on the bicycle ergometer. RÉSUMÉ Capacité aérobique maximale chez de jeunes infirmes moteurs cérébraux spastiques La capacité aérobique maximale au test de bicyclette ergométrique a été étudiée chez neuf enfants (âges de 11 à 12 ans) et cinq jeunes gens (âgés de 19 à 23 ans), tous présentant une forme spastique d'infirmité motrice cérébrale; une comparaison a été faite avec un groupe contrôle non handicapé. Les résultats ont montré des valeurs plus faibles dans la fréquence cardiaque, l'absorption d'oxygène par kilo de poids, la ventilation par kilo de poids et la concentration sanguine en lactate pour la majorité du groupe spastique. La capacité de travail physique du groupe handicapé atteignait environ 50 pour cent des valeurs correspondantes obtenues chez les contrôles non handicapés. L'efficience mécanique pauvre dans le groupe spastique est la conséquence d'une absorption d'oxygène élevée pour le travail fourni. La performance mécanique pauvre est liée principalement à l'énergie supplémentaire exigée par les modifications qualitatives du muscle (hypertonie constante), les mouvements involontaires et les mouvements d'équilibration durant les exercices sur la bicyclette ergométrique. ZUSAMMENFASSUNG Maximale Sauerstoffkapazitat bei jungen Leuten mit einer spastischen Cerebralparese Bei neun Kindern (im Alter von 11 bis 12 Jahren) und fünf jungen Männern (im Alter von 19 bis 23 Jahren), die alle eine spastische Cerebralparese hatten, wurde die maximale Sauerstoffkapazitat bei Fahrradergometertests untersucht und mit gesunden Kontrollen verglichen. Die Mehrzahl der Spastiker hatte eine niedrigere Herzfrequenz, Sauerstoffaufnahme/kg, Atemminutenvolumen/kg und Laktatkonzentration im Blut. Die physische Arbeitsleistung der behinderten Gruppe betrug etwa 50 Prozent von der der gesunden Kontrollen. Geringe mechanische Effizienz bei der Spastikergruppe ist die Folge einer hohen Sauerstoffaufnahme im Verhältnis zur geleisteten Arbeit. Die Ursache für die schlechte mechanische Leistung besteht darin, dass zusätzliche Energie für das Wechselspiel im Muskeltonus (konstante Hypertonie), für unwillkürliche Bewegungen und zum Halten des Gleichgewichtes auf ...

Identification of a core set of exercise tests for children and adolescents with cerebral palsy: a Delphi survey of researchers and clinicians

“…[1][2][3][4] These poor fitness levels have been well documented by means of exercise tests. Moreover, exercise testing has been used as a primary outcome measure of therapy and exercise programmes in children and adolescents with CP.…”

Aerobic fitness and lifestyle with non-exercise physical activity in adults with cerebral palsy

“…Aerobic fitness of children or athletes with cerebral palsy has been vigorously investigated by Bar-Or 10) , Fernandez et al 23,24) , Lundberg 25,26) , Maltais et al [27][28][29][30] , van den Berg-Emons et al [31][32][33][34] , and other researchers since the 1960s. These studies were based on work physiology that was mainly established by Åstrand et al 9) .…”

“…These included several empirical studies, most of which have been forgotten. However, some work physiology concerning this particular field of rehabilitation has survived because these studies provided insights into the improvement of residual function (i.e., aerobic fitness) in children or athletes with cerebral palsy rather than the recovery of lost function 3,10,[25][26][27][28] . However, only a few recent studies by researchers like Nieuwenhuijsen et al 55,56) and Satonaka, et al [19][20][21][22] have reported on nonathletic adults with cerebral palsy rated to GMFCS level III or IV.…”

“…Instead, Lundberg measured V ・ O2max directly using the maximal exercise test and a cycle ergometer 25) and demonstrated low aerobic fitness levels in individuals with cerebral palsy compared to age-matched healthy controls 26) . Bar-Or also directly measured V ・ O2max in children and adolescents with cerebral palsy; values were 10% -30% lower than those of their healthy counterparts 10) .…”

“…This work physiology was originally intended to provide practical information to athletes to improve their performance. Since the 1960s, physiological studies have mostly focused on the wellness of children 3,10,[25][26][27][28][31][32][33][34][35][36][37][38][39][40][41][42][43] or athletes [44][45][46][47][48][49][50][51][52][53][54] with cerebral palsy mainly rated to Gross Motor Function Classification System (GMFCS) level I or II. In the late twentieth century, many new remedies proliferated one after another in an attempt to recover loss of function in children with cerebral palsy.…”