Body mass index and fitness in high-functioning children and adolescents with cerebral palsy: What happened over a decade?

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Highlights

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    Performance-related fitness in children and adolescents with CP was better for the 2014 cohort as compared to the 2004 cohort.

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    VO2peak values did not change over 10 years.

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    Currently available reference values might underestimate performance-related fitness of children and adolescents with CP today.

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    Body mass and BMI were substantially higher for the 2014 cohort; combination of gained muscle- and fat mass?

Abstract

Background

In recent decades, improving fitness has become an important goal in rehabilitation medicine in children and adolescents with cerebral palsy (CP).

Aims

To compare body mass index (BMI), performance-related fitness, and cardiorespiratory fitness of children with CP measured in 2014 with a comparable sample from 2004.

Methods and procedures

In total, 25 high-functioning children with CP (i.e., GMFCS I–II) measured in 2004 (13 boys; mean age 13.2 (2.6) years) were matched to 25 children measured in 2014. Outcomes included body mass and BMI, muscle power sprint test (MPST), 10 × 5 m sprint test, and a shuttle run test (SRT). Data of 15 participants from 2004 (10 boys; mean age 12.6 (2.5) years) were matched and analysed for VO2peak.

Outcomes and results

Body mass and BMI were higher (both: p < 0.05) in the 2014 cohort compared to the 2004 cohort. Further, performance-related fitness was better for the 2014 cohort on the MPST (p = 0.004), the 10 × 5 m sprint test (p = 0.001), and the SRT (p < 0.001). However, there were no differences for VO2peak.

Conclusions and implications

In high-funcitoning children with CP, there are positive ecological time trends in performance-related fitness, but not in VO2peak between 2004 and 2014. The substantial higher body mass and BMI is alarming and requires further investigation.

Section snippets

What this paper adds

In recent decades, improving fitness levels of children and adolescents with cerebral palsy (CP) has become an important goal in rehabilitation medicine. Published studies related to exercise training programs for children and adolescents with CP have shown positive effects. However, it usually takes time for scientific results to be implemented in clinical practice. This study has the unique opportunity to study, with an timeframe of 10 years, if body mass, BMI and fitness levels of children

Methods

For the current study, data collected in 2014 (Zwinkels et al., 2015) were compared to two datasets from two different studies performed in 2004. (Verschuren, Takken, Ketelaar, Gorter, & Helders, 2006; Verschuren, Takken et al., 2007, Verschuren, Ketelaar et al., 2007) Data collection was administered similarly, since two researchers (OV, TT) involved in the 2004-studies supervised data collection in 2014.

Results

For body mass, BMI and performance-related fitness, participant characteristics of 25 children and adolescents with CP from both the 2004 and 2014 sample are presented in Table 1. Sex and GMFCS-levels were equally divided; 13 boys and 15 classified at GMFCS-level I.

Discussion

This study compared body composition, performance-related fitness, and cardiorespiratory fitness in a representative cohort of high-functioning children with CP, GMFCS-level I and II, measured in 2014 with a comparable cohort from 2004. In the 2014 cohort, body mass and BMI were higher compared to the 2004 cohort. In the contrary, performance-related fitness was better for the 2014 cohort with regards to agility and both anaerobic and aerobic performance, as compared to the 2004 cohort.

Funding

This work was supported by the Dr. W.M. Phelps Foundation, and by an unconditional grant of the Dutch Organization of Health Research (ZONMW) [grant number 525001005].

References (28)

  • J.M. Butler et al.

    Effect of cardiorespiratory training on aerobic fitness and carryover to activity in children with cerebral palsy: a systematic review

    International Journal of Rehabilitation Research. Internationale Zeitschrift Für Rehabilitationsforschung. Revue Internationale De Recherches De Réadaptation

    (2010)
  • J. Darrah et al.

    Review of the effects of progressive resisted muscle strengthening in children with cerebral palsy: a clinical consensus exercise

    Pediatric Physical Therapy

    (1997)
  • F.K. Dos Santos et al.

    Secular trends in physical fitness of Mozambican school-aged children and adolescents

    American Journal of Human Biology: The Official Journal of the Human Biology Council

    (2015)
  • S.M. Dyrstad et al.

    Aerobic fitness in young Norwegian men: a comparison between 1980 and 2002

    Scandinavian Journal of Medicine & Science in Sports

    (2005)
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    Sport-2-Stay-Fit study group:.FJG Backx (Department of Rehabilitation, Nursing Science and Sports, and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands), JF de Groot (University of Applied Sciences, Utrecht, the Netherlands), T Takken (Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, the Netherlands), DW Smits (Department of Rehabilitation, Nursing Science and Sports, and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands), O Verschuren (Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus and, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands), JMA Visser-Meily (Department of Rehabilitation, Nursing Science and Sports, and Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands), MJ Volman (Faculty of Social Sciences, Department of General and Special Education, Utrecht University, Utrecht, the Netherlands), HW Wittink (University of Applied Sciences, Utrecht, the Netherlands), M Zwinkels (Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus and, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands), T Nijboer (Department of Rehabilitation, Nursing Science and Sports, and Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands), R van de Schoof (University of Applied Sciences, Arnhem and Nijmegen, the Netherlands), G Steenweg (Windesheim University of Applied Sciences, Zwolle, the Netherlands)

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