Impact of Comorbidities on Physical Activity in Children with Cerebral Palsy

ABSTRACT Introduction: Cerebral palsy (CP) is commonly associated with various comorbidities that may affect children's engagement in physical activity. This study aimed to investigate the individual and cumulative effects of common comorbid conditions on physical activity participation in children with CP. Objective: To examine how different comorbidities influence physical activity levels in children with CP. Methods: A cross-sectional study was conducted with 67 children diagnosed with CP (aged 5–18 years). Data on comorbidities, including visual and hearing impairments, learning disabilities, scoliosis, hip dislocation, epilepsy, and hydrocephalus, were collected via parent-reported questionnaires. Physical activity participation was assessed using the Physical Activity Questionnaire for Children (PAQ-C). Results: Children with learning disabilities, scoliosis, and hip dislocation had significantly lower PAQ-C scores compared to those without these conditions (p < 0.001 for each). No statistically significant differences were observed between children with and without visual or hearing impairments. A significant negative correlation was found between the total number of comorbidities and physical activity levels (r = -0.438, p < 0.001). Conclusion: Not all comorbidities equally affect physical activity in children with CP. Learning difficulties, orthopedic problems, and multiple coexisting conditions are particularly associated with decreased activity. These findings underscore the importance of individualized and multidisciplinary strategies to address these barriers and enhance physical activity participation among children with CP. Keyswords: Cerebral Palsy, Comorbidities, Pediatric Rehabilitation, Physical Activity.