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Knight Lozano R, Shannon H, Gilby J, Goddard S, Turner L, Marsden J. Community-based respiratory health measures in children and young people with cerebral palsy: A scoping review. Dev Med Child Neurol 2024; 66:849-862. [PMID: 38269611 DOI: 10.1111/dmcn.15854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024]
Abstract
AIM To identify, map, and describe outcome measurement domains and instruments used within a community setting to assess respiratory health in children and young people aged 1 to 18 years, diagnosed with cerebral palsy (CP). METHOD A scoping review methodology informed structured searches in nine databases, grey literature, and registries, conducted in August 2021 (updated in February 2023). Articles were screened for eligibility by two independent researchers. Any outcome measurement instruments used to assess respiratory health or associated impact were extracted, categorized, and mapped to health and health-related domains of the International Classification of Functioning, Disability, and Health. RESULTS Seventy-six outcome measurement instruments were identified across 78 articles worldwide between 1970 and 2023. These were categorized into 'Body functions and structures' (n = 20), 'Activity and performance' (n = 22), and 'Participation and quality of life' (n = 19), with a further 15 mapped to 'Health care resources use'. INTERPRETATION No consensus of 'what' to measure and 'how' to measure respiratory health in children and young people with CP was found. Moreover, many measures were not replicable in individuals with more severe forms of CP, excluding those at increased risk of respiratory-related morbidity and mortality. Further research is required to agree important outcome domains and associated measures in research and clinical practice. WHAT THIS PAPER ADDS A limited number and size of experimental designs were found. Seventy-six measures were identified to assess respiratory health in cerebral palsy. No consensus was found in 'what' or 'how' to measure respiratory health. Many measures were not replicable in children and young people at risk of poorer respiratory health outcomes. Children and young people with comorbidities and learning disability were frequently excluded from studies.
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Affiliation(s)
| | - Harriet Shannon
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Sian Goddard
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Leanne Turner
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
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Lai B, Oster RA, Davis D, Bright L, Fisher G, Wilroy J, Kim Y, Young R, Wright A, Sinha T, Rimmer JH. Telehealth Movement-to-Music With Arm-Based Sprint-Intensity Interval Training to Improve Cardiometabolic Health and Cardiorespiratory Fitness in Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e56499. [PMID: 38441939 PMCID: PMC10951837 DOI: 10.2196/56499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Children with mobility disabilities, including those with cerebral palsy, have limited options and limited time to exercise to manage their cardiometabolic health and cardiorespiratory fitness. Regular cardiovascular exercise during childhood is a critical health behavior for preventing health decline in adulthood. Thus, there is an urgent need for accessible, age-appropriate, convenient exercise modalities in this group. Sprint-intensity interval training (SIT), combined with telehealth procedures, may be ideal for children with disabilities. SIT includes repetitive bouts of maximal exercise effort combined with rest periods, which can be effective in eliciting comparable results to moderate-exercise training with very short training durations. OBJECTIVE This phase 1 pilot feasibility randomized controlled trial aims to investigate the potential effects of a 12-week SIT program on indicators of cardiorespiratory fitness and cardiometabolic health among children with cerebral palsy. An ancillary aim is to evaluate the feasibility of the program through several process feasibility metrics. METHODS This study uses a 2-armed parallel group design. A total of 50 physically inactive children with cerebral palsy (aged 6-17 years) will be randomly allocated into 1 of 2 groups: a 12-week SIT or a waitlist control group that continues habitual activity for 12 weeks. The SIT prescription includes 3 tele-supervised sessions per week with 30 repeated sequences of 4 seconds of maximal arm exercise, with active recovery, warm-up, and cooldown periods (for an approximately 20-minute total session). SIT includes guided videos with child-themed arm routines and music. The exercise sessions will be remotely supervised through a web-based videoconference application and include safety monitoring equipment. Outcomes are measured at pre- and postintervention (weeks 0 and 13, respectively). Health outcome measures include peak oxygen consumption (VO2 peak), measured by a graded exercise test; high-sensitivity C-reactive protein and blood insulin, hemoglobin A1c, triglycerides, and cholesterol using a finger stick dried blood spot test; blood pressure, using a sphygmomanometer; and body composition (total mass, total lean mass, tissue % lean, and tissue % fat) using dual x-ray absorptiometry. Feasibility will be evaluated by the following metrics: adverse events or problems experienced throughout the intervention related to participant safety; perceived enjoyment; and recruitment, enrollment, and attrition rates. RESULTS Recruitment procedures started in November 2023. All data are anticipated to be collected by February 2025. Full trial results are anticipated to be analyzed and submitted for publication by March 2025. Secondary analyses of data will be subsequently published. CONCLUSIONS This trial tests an accessible and low-cost exercise program that leverages principles of high-intensity exercise to provide a convenient program for children with physical disabilities. Knowledge obtained from this study will inform the development of a larger trial for improving the cardiometabolic health, cardiorespiratory fitness, and well-being of children with physical disabilities. TRIAL REGISTRATION ClinicalTrials.gov NCT05619211; https://clinicaltrials.gov/study/NCT05619211. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56499.
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Affiliation(s)
- Byron Lai
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Robert A Oster
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Drew Davis
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Larsen Bright
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gordon Fisher
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jereme Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Yumi Kim
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Raven Young
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ashley Wright
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tanvee Sinha
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James H Rimmer
- Dean's Office, School of Health Professions, National Center on Health, Physical Activity and Disability, Birmingham, AL, United States
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Santos KP, SiIva VMMD, Reis IFD, Aquino MRCD, Lana MRV, Teixeira CMMDF. Physical conditioning in children and adolescents with cerebral palsy: Systematic review and meta-analysis. J Bodyw Mov Ther 2023; 35:158-163. [PMID: 37330763 DOI: 10.1016/j.jbmt.2023.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/01/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Cerebral palsy (CP) can be described as a group of permanent non-progressive disorders that occur in the developing fetal or infant brain. Studies have shown that children and adolescents with CP have low cardiorespiratory fitness and higher energy expenditure during daily activities when compared to typical children. Therefore, interventions focused on the physical conditioning of this population could be critical. OBJECTIVE To evaluate the effect of physical conditioning training on distance walked and maximum oxygen consumption (VO₂ max) in individuals with CP, through a systematic review. METHOD Two independent researchers performed systematic searches in the PUBMED, SciELO, PEDro, ERIC, and Cochrane databases using the search terms "physical fitness", "aerobic training" or "endurance" combined with "cerebral palsy". INCLUSION CRITERIA (1) population (children and adolescents with CP between 5 and 18 years old); (2) type of study (experimental studies); (3) type of intervention (physical conditioning protocols); (4) outcome (distance walked in the 6 min walking test - 6MWT, and VO₂ max). RESULTS 386 studies were identified and 5 articles were considered eligible. After physical conditioning training, there was an increase of 46.34 m (p = 0.07) and 5.93. ml. kg-1. min -1 (p < 0.001) in the 6MWT and VO₂ max, respectively. CONCLUSION Physical conditioning training appears to be clinically beneficial to the cardiorespiratory fitness of children and adolescents with CP.
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Affiliation(s)
- Kamilla Passini Santos
- Physiotherapist Graduated from the Newton Paiva University Center, Belo Horizonte, MG, Brazil.
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Poon ETC, Wongpipit W, Sun F, Tse ACY, Sit CHP. High-intensity interval training in children and adolescents with special educational needs: a systematic review and narrative synthesis. Int J Behav Nutr Phys Act 2023; 20:13. [PMID: 36759853 PMCID: PMC9909882 DOI: 10.1186/s12966-023-01421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND High-intensity interval training (HIIT) has been promoted as a time-efficient exercise strategy to improve health and fitness in children and adolescents. However, there remains little consensus in the literature regarding its efficacy in children and adolescents with special educational needs (SEN). This study aimed to examine HIIT as a means of improving key health and fitness parameters in children and adolescents with SEN. METHODS A systematic search was conducted on eight databases (MEDLINE, Embase, SPORTDiscus, Web of Science, Scopus, PsycINFO, CINAHL, and Cochrane Library). Studies were eligible if they 1) included an HIIT protocol, 2) examined parameters related to both physical and mental aspects of health and fitness, and 3) examined children and adolescents with SEN aged 5-17 years. RESULTS Of the 1727 studies yielded by the database search, 13 (453 participants) were included and reviewed. We found that HIIT generally improved body composition, physical fitness, and cardiometabolic risk biomarkers across a spectrum of SEN (e.g., attention deficit hyperactivity disorder, cerebral palsy, developmental coordination disorder, and mental illness). Improvements in mental health and cognitive performance following HIIT have also been observed. CONCLUSION This review provides up-to-date evidence for HIIT as a viable exercise strategy for children and adolescents with SEN. Further research investigating the benefits of HIIT in a wider range of SEN populations is warranted. TRIAL REGISTRATION This study was registered in the International Prospective Register of Systematic Review (PROSPERO; registration number CRD42022352696).
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Affiliation(s)
- Eric Tsz-Chun Poon
- grid.419993.f0000 0004 1799 6254Department of Health and Physical Education, The Education University of Hong Kong, Taipo, Hong Kong
| | - Waris Wongpipit
- Division of Health and Physical Education, Faculty of Education, Chulalongkorn University, Bangkok, Thailand. .,Thailand Physical Activity Knowledge Development Centre, Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand.
| | - Fenghua Sun
- grid.419993.f0000 0004 1799 6254Department of Health and Physical Education, The Education University of Hong Kong, Taipo, Hong Kong
| | - Andy Choi-Yeung Tse
- grid.419993.f0000 0004 1799 6254Department of Health and Physical Education, The Education University of Hong Kong, Taipo, Hong Kong
| | - Cindy Hui-Ping Sit
- grid.10784.3a0000 0004 1937 0482Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
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Starowicz J, Pratt K, McMorris C, Brunton L. Mental Health Benefits of Physical Activity in Youth with Cerebral Palsy: A Scoping Review. Phys Occup Ther Pediatr 2022; 42:434-450. [PMID: 35484717 DOI: 10.1080/01942638.2022.2060058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Children and adolescents with cerebral palsy (CP) are at heightened risk for mental health problems. Physical activity is an effective strategy to promote quality of life (QoL) and reduce mental health symptoms along with evidence-based therapies. This study described existing literature examining the mental health outcomes (e.g., QoL, well-being, anxiety, and depression) of physical activity interventions in children and adolescents with CP to help inform the implementation of physical activity interventions for this population. METHODS Ascoping review framework was used to map the existing quantitative literature. RESULTS The search returned 243 articles; after titles, abstracts, and full manuscripts were reviewed, 21 articles were included. The association between physical activity and QoL was examined in most studies (n = 17) with mixed findings. Eight studies documented at least one significant positive association between physical activity and QoL, and four found that physical activity interventions were highly enjoyable. Only one study assessed anxiety and/or depression following a PA intervention. CONCLUSIONS Physical activity may benefit aspects of QoL and mental health symptoms; however, this was not a consistent finding in the existing literature. Along with other therapies, physical activity interventions may be valuable in improving QoL, and in turn, the mental health symptoms of children with CP.
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Affiliation(s)
- Jessica Starowicz
- Health and Rehabilitation Sciences, Western University, London, Canada
| | - Karen Pratt
- Health and Rehabilitation Sciences, Western University, London, Canada
| | - Carly McMorris
- Werklund School of Education, University of Calgary, Calgary, Canada
| | - Laura Brunton
- School of Physical Therapy, Western University, London, Canada
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Owusu Ansa EO, Mprah WK, Moses MO, Owusu I, Acheampong E. Effect of Community-Based Functional Aerobic Training on Motor Performance and Quality of Life of Children with Spastic Cerebral Palsy. Ethiop J Health Sci 2021; 31:505-516. [PMID: 34483607 PMCID: PMC8365498 DOI: 10.4314/ejhs.v31i3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/13/2020] [Indexed: 11/26/2022] Open
Abstract
Background Efficacies of community-based exercise programmes have been well reported but there is scarce information on the expediency of community-based rehabilitation in a society where many of children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. The study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). Methods Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I – II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40–80% maximum heart rate. Gross motor function (GMF), walk distance and quality of life were assessed pre and post CBFAE training. Results Significant improvement observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking+running+jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in Pain and impact of disability (67.93%, P=.049) and Participation and physical health (60.00%, P=.042). Conclusion CBFAE training contributes majorly to improved standing, walking, jumping and running and selfesteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances.
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Affiliation(s)
- Evans Osei Owusu Ansa
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Physiotherapy and Sports Science, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Kwadwo Mprah
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Monday Omoniyi Moses
- Department of Physiotherapy and Sports Science, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Owusu
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Enoch Acheampong
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Ansa OEO, Mprah KW, Moses MO, Owusu I, Acheampong E. Effect of Community-Based Functional Aerobic Training on Motor Performance and Quality of Life of Children with Spastic Cerebral Palsy. Ethiop J Health Sci 2021; 31:381-392. [PMID: 34158790 PMCID: PMC8188077 DOI: 10.4314/ejhs.v31i2.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Efficacies of community-based exercise programmes have been well reported, but there is scarce information on the expediency of community-based rehabilitation in a society where many children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. This study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). Methods Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I – II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40–80% maximum heart rate. Gross motor function (GMF), walking distance and quality of life were assessed pre and post CBFAE training. Results Significant improvement was observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking + running+ jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE were observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in pain and impact of disability (67.93%, P=.049) and participation and physical health (60.00%, P=.042). Conclusion CBFAE training contributes majorly to improved standing, walking, jumping and running and self-esteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances.
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Affiliation(s)
- Osei Evans Owusu Ansa
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Physiotherapy and Sports Science, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Wisdom Mprah
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Monday Omoniyi Moses
- Department of Physiotherapy and Sports Science, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Owusu
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Enoch Acheampong
- Department of Health Education, Promotion and Disability Studies, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Leahy AA, Kennedy SG, Smith JJ, Eather N, Boyer J, Thomas M, Shields N, Dascombe B, Lubans DR. Feasibility of a school-based physical activity intervention for adolescents with disability. Pilot Feasibility Stud 2021; 7:120. [PMID: 34088346 PMCID: PMC8175924 DOI: 10.1186/s40814-021-00857-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents with disability are less active and have lower levels of physical fitness than their typically developing peers. Schools are ideal settings to address this; however, few school-based interventions have been designed and evaluated among this group. Therefore, the aim of this pilot study was to determine the feasibility of a time-efficient school-based physical activity intervention for adolescents with disability. METHODS A non-randomized pilot trial was conducted with adolescents in the special education unit at one secondary school in New South Wales, Australia. Sixteen grade 11 and 12 students (aged 17.3 ± 0.7 years) participated in the 2-month physical activity intervention. Two classroom teachers were trained to facilitate the delivery of a high-intensity interval training (HIIT) program, known as Burn 2 Learn adapted (B2La). Teachers were asked to deliver 2-3 weekly HIIT sessions for a period of 2 months. Four domains of feasibility (acceptability, implementation, adaptability, and practicality) were assessed using quantitative measures at the student and teacher levels (e.g., observations, process evaluation questionnaires, and heart rate [HR] monitoring). Data were also collected from three learning and support teachers who assisted classroom teachers with intervention delivery. Preliminary efficacy of the intervention on measures of adolescents' functional capacity (6-min walk/run test) and muscular fitness (sit-to-stand test and modified push-up test) were analyzed using paired sample t-tests. RESULTS Moderate-to-high levels of program satisfaction were reported by both students (80% rated "Good" or "Excellent") and teachers (100% rated "Good" or "Excellent"). Teachers reported delivering 2.5 ± 0.7 sessions per week during the study. Based on researcher session observations, the program was delivered effectively by teachers (14/20). However, HR data indicated session intensity was lower than intended. The program was considered "adaptable" by teachers, with several observed modifications to HIIT sessions to cater for the needs of adolescents with disability. No adverse events were reported. We observed improvements in preliminary efficacy measures. CONCLUSIONS Our findings suggest it is feasible to train teachers to deliver a school-based HIIT program for adolescents with disability. Evaluation of B2La within a larger-scale effectiveness trial is warranted. TRIAL REGISTRATION ACTRN12621000219886 .
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Affiliation(s)
- Angus A Leahy
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - Sarah G Kennedy
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jordan J Smith
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - Narelle Eather
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - James Boyer
- New South Wales Department of Education, Sydney, New South Wales, Australia
| | - Matthew Thomas
- New South Wales Department of Education, Sydney, New South Wales, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Victoria, Australia
| | - Ben Dascombe
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, School of Education, University of Newcastle, Callaghan, New South Wales, Australia.,Applied Sport Science and Exercise Testing Laboratory, School of Life and Environmental Sciences, University of Newcastle, Ourimbah, New South Wales, Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, School of Education, University of Newcastle, Callaghan, New South Wales, Australia.
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Sol ME, Verschuren O, Horemans H, Westers P, Visser-Meily JMA, De Groot JF. The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair. Disabil Rehabil 2021; 44:4398-4407. [PMID: 33874820 DOI: 10.1080/09638288.2021.1907456] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. METHODS Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. RESULTS Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. CONCLUSIONS A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
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Affiliation(s)
- Marleen E Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Henricus Horemans
- Department of Rehabilitation Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Paul Westers
- Department of Biostatistics and Research Support, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Janke F De Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
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Leahy AA, Mavilidi MF, Smith JJ, Hillman CH, Eather N, Barker D, Lubans DR. Review of High-Intensity Interval Training for Cognitive and Mental Health in Youth. Med Sci Sports Exerc 2021; 52:2224-2234. [PMID: 32301856 DOI: 10.1249/mss.0000000000002359] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE High-intensity interval training (HIIT) has emerged as a time-efficient strategy to improve children's and adolescents' health-related fitness in comparison to traditional training methods. However, little is known regarding the effects on cognitive function and mental health. Therefore, the aim of this systematic review was to evaluate the effect of HIIT on cognitive function (basic information processing, executive function) and mental health (well-being, ill-being) outcomes for children and adolescents. METHODS A systematic search was conducted, and studies were eligible if they 1) included a HIIT protocol, 2) examined cognitive function or mental health outcomes, and 3) examined children or adolescents (5-18 yr). Separate meta-analyses were conducted for acute and chronic studies, with potential moderators (i.e., study duration, risk of bias, participant age, cognitive demand, and study population) also explored. RESULTS A total of 22 studies were included in the review. In acute studies, small to moderate effects were found for executive function (standardized mean difference [SMD], 0.50, 95% confidence interval [CI], 0.03-0.98; P = 0.038) and affect (SMD, 0.33; 95% CI, 0.05-0.62; P = 0.020), respectively. For chronic studies, small significant effects were found for executive function (SMD, 0.31; 95% CI, 0.15-0.76, P < 0.001), well-being (SMD, 0.22; 95% CI, 0.02-0.41; P = 0.029), and ill-being (SMD, -0.35; 95% CI, -0.68 to -0.03; P = 0.035). CONCLUSIONS Our review provides preliminary review evidence suggesting that participation in HIIT can improve cognitive function and mental health in children and adolescents. Because of the small number of studies and large heterogeneity, more high-quality research is needed to confirm these findings.
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Affiliation(s)
- Angus A Leahy
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, AUSTRALIA
| | - Myrto F Mavilidi
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, AUSTRALIA
| | - Jordan J Smith
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, AUSTRALIA
| | | | - Narelle Eather
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, AUSTRALIA
| | - Daniel Barker
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, AUSTRALIA
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, AUSTRALIA
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Depiazzi J, Smith N, Gibson N, Wilson A, Langdon K, Hill K. Aquatic high intensity interval training to improve aerobic capacity is feasible in adolescents with cerebral palsy: pilot randomised controlled trial. Clin Rehabil 2020; 35:222-231. [PMID: 32907375 DOI: 10.1177/0269215520956499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate feasibility of aquatic high intensity interval training for adolescents with cerebral palsy, who can ambulate independently but may choose a mobility aid in some circumstances. DESIGN Pilot randomised controlled trial. METHOD Following baseline assessments, participants were randomised to usual care or ten weeks of twice weekly aquatic high intensity interval training. Each class comprised 10 one-minute exercise intervals separated by one-minute rest. High intensity exercise was defined as the attainment of ⩾80% of peak heart rate measured by telemetry. SETTING Tertiary paediatric hospital. MAIN MEASURES Primary outcomes related to the feasibility of the protocol to progress to a definitive trial. Consumer feedback was obtained. RESULTS Of 119 potential participants, 46 appeared eligible and 17 consented, resulting in a recruitment fraction of 37% (95% CI 23-52). Twelve completed baseline assessments and were randomised (5 males; 14 years 7 months SD 2 years 0 months). In the intervention group, of the 1190 exercise stations (across all participants and sessions), heart rate data were available for 1180 stations and high intensity exercise was achieved during 1111 stations (93%, 95% CI 92-95). All randomised participants completed the study and reported that the intervention was fun and provided friendship opportunities. There were no major adverse events or exacerbation of pain. CONCLUSIONS Aquatic high intensity interval training in ambulant adolescents with cerebral palsy is feasible, while maintaining adherence and fidelity. Uncertainty remains on the efficacy of the intervention, highlighting the need for a large definitive trial.
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Affiliation(s)
- Julie Depiazzi
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, WA, Australia.,Physiotherapy Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Nadine Smith
- Physiotherapy Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Noula Gibson
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, WA, Australia.,Physiotherapy Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Andrew Wilson
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, WA, Australia.,Respiratory Medicine Department, Perth Children's Hospital, Perth, Western Australia, Australia.,Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia.,Discipline of Paediatrics, University of Western Australia, Perth, Western Australia, Australia
| | - Katherine Langdon
- Paediatric Rehabilitation Medicine Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, WA, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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Abe H, Inoue K, Kozuka N. A Preliminary Evaluation of Energy Efficiency for Children with Cerebral Palsy for Driving A Manual Wheelchair and Walking: Use of the Total Heart Beat Index. Dev Neurorehabil 2020; 23:383-389. [PMID: 31739713 DOI: 10.1080/17518423.2019.1692947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aims: This study aims to compare the total heart beat index (THBI) in evaluating energy efficiency between using a manual wheelchair and walking for children with cerebral palsy (CP). Methods: The energy efficiency was measured in 21 participants with CP (mean age, 13.6 ± 3.4 years) who walk or drive a manual wheelchair using a square course. THBI was calculated as total number of heart beats during the exercise period/total distance traveled. Results: Significant differences in the THBI were observed between Gross Motor Function Classification System (GMFCS) levels III and IV (p = .049, effect size = 1.60). No significant differences in THBI were observed between GMFCS levels II and III or between GMFCS levels II and IV (p > .05). Conclusions: The energy efficiency of children with CP who use a manual wheelchair in this study was equal to or better than that for walking.
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Affiliation(s)
- Hirokazu Abe
- Department of Health Care and Child Development, Saitama Children's Medical Center , Saitama, Japan.,Master Course of Health Sciences, Department of Physical Therapy, Graduate School, Sapporo Medical University , Sapporo, Japan
| | - Kazuhiro Inoue
- Division of Rehabilitation Medicine, Hokkaido Medical Center for Child Health and Rehabilitation , Sapporo, Japan
| | - Naoki Kozuka
- Department of First Division of Physical Therapy, School of Health Sciences, Sapporo Medical University , Sapporo, Japan
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Abd El-Nabie WA, Attia MA. Immediate effect of maximal treadmill walking on muscle fatigue and postural stability in children with cerebral palsy. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2019. [DOI: 10.4103/bfpt.bfpt_26_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
PURPOSE To investigate the effects of high-intensity interval training (HIT) on physical fitness and cardiometabolic health in youth with physical disabilities. METHODS For this quasi-experimental study 70 participants were recruited from schools for special education and divided into runners and users of wheelchairs. HIT was performed for 8 weeks, twice a week, containing 30 seconds all-out exercises. RESULTS Exercise adherence was 84.5%. Following HIT, there were improvements in anaerobic performance, agility, aerobic performance, and systolic and diastolic blood pressure. There were no changes in peak oxygen uptake ((Equation is included in full-text article.)O2peak), arterial stiffness, body composition, lipid profile, and fasting glucose. CONCLUSIONS Both anaerobic and aerobic performance improved after HIT, with no changes in (Equation is included in full-text article.)O2peak. There were no effects on cardiometabolic health, except for a decrease in blood pressure.
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Cesar GM, Buster TW, Burnfield JM. Cardiorespiratory fitness, balance and walking improvements in an adolescent with cerebral palsy (GMFCS II) and autism after motor-assisted elliptical training. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1536764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Guilherme M. Cesar
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Thad W. Buster
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Judith M. Burnfield
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
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Does Home-Based Progressive Resistance or High-Intensity Circuit Training Improve Strength, Function, Activity or Participation in Children With Cerebral Palsy? Arch Phys Med Rehabil 2018; 99:2457-2464.e4. [PMID: 30473019 DOI: 10.1016/j.apmr.2018.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/23/2018] [Accepted: 06/04/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Does home-based progressive resistance or high-intensity circuit training improve strength, function, activity, or participation in children with cerebral palsy (CP)? DESIGN This was the first study on high-intensity circuit training for children with CP. This study was conducted as a randomized prospective controlled pilot study. SETTING Evaluation took place at the gait laboratory of the university hospital, training sessions were performed at home. PARTICIPANTS Children (N=22) with CP (average age: 12y, 10mo, 19 Gross Motor Function Classification System level I, 3 level II) were randomly assigned either to progressive resistance training (PRT) or high-intensity circuit training (HICT). INTERVENTIONS The PRT group trained with progressive overload, while the HICT group performed as many repetitions as possible within 30-second intervals (8wk, 3 times weekly in both groups). MAIN OUTCOME MEASURES Outcome measures stretched over all domains of the International Classification of Functioning, Disability and Health and included muscle strength, muscle power sprint test (MPST), timed stairs test (TST), 6-minute walking test, Gait Profile Score (GPS), timed Up and Go test (TUGT) and participation questionnaires. RESULTS Only the HICT group was able to improve strength. Furthermore, the HICT group scored better in the MPST, while PRT participants improved in the TST and TUGT. The HICT-group was able to show improvement in the subscores of the parent-reported participation questionnaire. Other measures of mobility or participation did not change. CONCLUSIONS Both programs improved function specific to intervention. However, only the HICT group showed significant strength and participation improvements. Compliance was decent in both groups, but the average training unit was shorter in the HICT group. Both exercise programs showed functional benefits, but HICT might be the preferable option for strengthening in highly functional children with CP.
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