Major health gaps in people with severe spastic cerebral palsy: need for public health interventions

Abstract Background Individuals with severe spastic cerebral palsy (CP) show limited physical activity (PA) due to barriers such as inaccessible environments and a lack of inclusive programs [1]. This increases the risk of developing non-communicable diseases [2]. Despite these risks, they remain underrepresented in public health strategies, likely due to limited data on PA and health outcomes. Therefore, the aim of this study was to improve our knowledge of the cardiorespiratory deficits and activity levels of people with moderate to severe CP. Methods In this cross-sectional study, 12 individuals with severe spastic CP (GMFCS III-IV, 22.7 ± 4.9 y) and 14 TD controls (22.9 ± 4.7 y), all naïve to frame running, completed a 6-minute Frame Running test (6-MFRT). Distance covered was measured, and continuous spirometric data recorded alongside perceived exertion via the Borg RPE scale. Additionally, habitual PA was assessed using accelerometry and activity diaries over seven days. Group differences were evaluated with independent t-tests (p < 0.05). Results Despite similar perceived exertion levels, the participants with CP covered significantly (p < 0.001) less distance in the 6-MFRT than their TD peers (-1445.1 m). Spirometry measurements revealed significantly (p < 0.01) lower peak oxygen uptake (-20.18 L/min/kg) and ventilation (-52.39 L/min), and smaller average tidal volumes (-12.48 ml/kg) with similar (p > 0.05) respiratory exchange ratio, breathing frequency, and peak heart rate. Preliminary PA assessment suggests that the individuals with CP engage in less PA. Conclusions These findings reveal significant deficits in PA and fitness among adults with severe spastic CP, highlighting the need for targeted public health strategies and inclusive programs. We recommend group-based exercise and accessible infrastructure to improve overall health outcomes in this population. References [1] Verschuren O et al. J Pediatr. 2012;161(3):488-94. [2] Peterson MD et al. JAMA. 2015;314(21):2303-5. Key messages • Individuals with severe CP show significant deficits in physical activity and fitness compared to TD peers. • Adaptive exercise is essential to improve overall health outcomes in individuals with CP.