Importance of Lifelong Exercise for Adults with Cerebral Palsy

By: Kathryn Blosser, PT, DPT, CBIS

Although cerebral palsy (CP) is a non-progressive condition, persons with CP often experience a decline of physical fitness and overall functional mobility independence with advancing age.

Research shows lifelong physical activity can reduce or prevent this decline.

In this article, we will learn what cerebral palsy is and also touch upon:

  • 4 ways physical activity helps protect the health of those with CP
  • Tips to start exercising
  • How much cardiorespiratory exercise adults with CP need
  • How much muscle strengthening/resistance training exercise adults with CP need

Let’s get started!

What is Cerebral Palsy?

The CDC defines cerebral palsy (CP) as: “A group of disorders that affect a person’s ability to move and maintain balance and posture. CP is the most common motor disability in childhood … CP is caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control his or her muscles. CP does not get worse over time, though the exact symptoms can change over a person’s lifetime.”

4 Ways Physical Activity Helps Protect the Health of Those with CP

Physical activity performed on a consistent, ongoing basis can have a protective role on health and has been shown to:

  • Reduce inflammation
  • Reduce overall risk of adverse health events
  • Improve maintenance of function
  • Reduce the risk of cardiac and metabolic disease

Tips to Start Exercising After Being Less Active

Simple changes to activity levels can have a big impact. This might include reducing sedentary behavior by standing instead of sitting or doing quick exercises periodically throughout the day while sitting or lying down.

  • Start training with a qualified professional such as an exercise physiologist, occupational therapist, and/or physical therapist
  • Start with simple, single joint movements, one side at a time
  • Train muscles through whatever range of motion is available and comfortable
  • Practice the movement before adding weight
  • Use straps, gloves, or flotation devices as needed to improve safety and comfort
  • Use manual assistance or special adaptation as needed

To improve consistency of physical activity, focus on exercises that are sport- or goal-motivated that you prefer and enjoy such as using a Wii or gaming system to engage in functional balance exercises or getting involved in adaptive sports for a team-based environment.

Below are research-based exercise guidelines for adults with cerebral palsy:

How Much Cardiorespiratory Exercise do Adults with CP Need?

  • Frequency:
    • If you are very deconditioned, start with 1-2 sessions per week and work up to the recommended levels of 3-5 sessions per week (Minimum frequency of 2-3 times per week)
  • Intensity:
    • 64-95% of maximum heart rate
  • Time/duration:
    • At least 20 minutes
    • 8 consecutive weeks for training 3 times per week
    • 16 consecutive weeks for training 2 times per week
  • Exercise type ideas:
    • Running or walking
    • Step ups
    • Stairs
    • Biking or cycling
    • Arm bike
    • Wheelchair propulsion
    • Swimming
    • Water aerobics
    • Stepper bike
    • Seated boxing
    • Elliptical use
    • Arm bike
    • Be sure to include a warm-up and cool-down
  • Impact:
    • Improve cardiorespiratory endurance
    • Reduced risk of cardiac and metabolic disease
    • Reduced blood pressure
    • Improved insulin metabolism
    • Improved cholesterol
    • Reduced inflammation

How Much Muscle Strengthening/Resistance Training Exercise do Adults with CP Need?

  • Frequency:
    • 2-4 times per week on non-consecutive days
  • Intensity:
    • Youth/beginner: no more than 10-15 reps for 1-2 sets
    • Intermediate/advanced: 6-12 reps for 2-4 sets
    • Adults should lift 60-80% of the weight they are able to lift one time; this is also called one rep max (1RM)
    • Work with a skilled provider to determine what intensity of exercise is appropriate
  • Time/duration:
    • 12-16 weeks needed for significant improvements
  • Type:
    • Progression from primarily single-joint, machine-based resistance exercise to machine and free-weight or body weight, multi-joint resistance exercise
  • Impact:
    • Reduced spasticity
    • Improvements in strength
    • Reduced risk of falls
    • Improved glucose levels and insulin metabolism
    • Increased bone mineral density
    • Improved tendon strength
    • Improved gross motor function

To learn more about our therapy treatment options and support group for cerebral palsy, please call (804) 764-1000 or send us a message.

 

References

Blanchard, Y., Gannotti, M., and Romney, W. (2016) Health-related fitness for children and adults with cerebral palsy. ACSM Sports Medicine Basics.

Peterson, M.D., Gordon, P.M. and Hurvitz, E.A. (2013), Chronic disease risk in cerebral palsy. Obes Rev, 14: 171-182. https://doi.org/10.1111/j.1467-789X.2012.01052.x

Verschuren, O., Peterson, M.D., Balemans, A.C.J. and Hurvitz, E.A. (2016), Exercise and physical activity recommendations for people with cerebral palsy. Dev Med Child Neurol, 58: 798-808. https://doi.org/10.1111/dmcn.13053

“What is Cerebral Palsy?” CDC, 2 Sept. 2021, https://www.cdc.gov/ncbddd/cp/facts.html.

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