Physical activity and its promotion, as well as the avoidance of sedentary behaviour, play important roles in health promotion and prevention of lifestyle‐related diseases. Guidelines for young people and adults with typical development are available from the World Health Organisation and American College of Sports Medicine. However, detailed recommendations for physical activity and sedentary behaviour have not been established for children, adolescents, and adults with cerebral palsy (CP). This paper presents the first CP‐specific physical activity and exercise recommendations. The recommendations are based on (1) a comprehensive review and analysis of the literature, (2) expert opinion, and (3) extensive clinical experience. The evidence supporting these recommendations is based on randomized controlled trials and observational studies involving children, adolescents, and adults with CP, and buttressed by the previous guidelines for the general population. These recommendations may be used to guide healthcare providers on exercise and daily physical activity prescription for individuals with CP.

To evaluate the effects of an 8-month training program with standardized exercises on aerobic and anaerobic capacity in children and adolescents with cerebral palsy. Pragmatic randomized controlled clinical trial with blinded outcome evaluation between July 2005 and October 2006. Participants were recruited from 4 schools for special education in the Netherlands. A total of 86 children with cerebral palsy (aged 7-18 years) classified at Gross Motor Function Classification System level I or II. Participants were randomly assigned to either the training group (n = 32) or the control group (n = 33). The training group met twice per week for 45 minutes to circuit train in a group format that focused on aerobic and anaerobic exercises. Aerobic capacity was assessed by the 10-m shuttle run test, and anaerobic capacity was assessed by the Muscle Power Sprint Test. Secondary outcome measures included agility, muscle strength, self-competence, gross motor function, participation level, and health-related quality of life. A significant training effect was found for aerobic (P < .001) and anaerobic capacity (P = .004). A significant effect was also found for agility (P < .001), muscle strength (P < .001), and athletic competence (P = .005). The intensity of participation showed a similar effect for formal (P < .001), overall (P = .002), physical (P = .005), and skilled-based activities (P < .001). On the health-related quality of life measure, a significant improvement was found for the motor (P = .001), autonomy (P = .02), and cognition (P = .04) domains. An exercise training program improves physical fitness, participation level, and quality of life in children with cerebral palsy when added to standard care. isrctn.org Identifier: ISRCTN77274716.

Purpose. To evaluate the intertester reliability of two methods for measuring lower-limb strength in children with cerebral palsy (CP). Method. Twenty-five subjects with CP (7 – 17 years of age) participated in this study. Lower-limb muscle strength was measured on 2 occasions using a Hand-held Dynamometer (HHD; break-method and make-method) and a 30-sec Repetition Maximum (RM) during three functional strength tests for the lower extremities. Reliability was measured using the intraclass correlation coefficients (ICCs), the standard error of measurement (SEM) and the coefficient of variation (CV). Results. The intertester reliability of strength measurement using a HHD was questionable with ICC values ranging from 0.42 – 0.73 for the break-method, and from 0.49 – 0.82 for the make-method. The SEM and CV (%) values ranged from 27.9 – 58.9 and 22.2 – 35.3% for the break-method, and from 30.6 – 52.7 and 16.2 – 56.2% for make-method. The intertester reliability of strength measurement using the 30-sec RM was acceptable with ICC values ranging from 0.91 – 0.96, and SEM and CV (%) values ranging from 1.1 – 2.6 and 10.9 – 39.9% for the functional exercises. Conclusion. The intertester reliability of measuring muscle strength of the lower extremities using a hand-held dynamometer is questionable. The intertester reliability of the 30-sec RM for the lower extremity is acceptable.

Resistance training of the lower limbs is now commonly used in clinical practice in children and adolescents with spastic cerebral palsy (CP). However, the effectiveness of this type of training is still disputed. The most recently published systematic review with meta-analysis included interventions such as electrical stimulation and resistance training and found insufficient evidence to support or refute the efficacy of these exercises in children with CP. Thus, the aim of this article is to evaluate the extent to which training protocols from the most recent randomized controlled trials are in keeping with the evidence for effective resistance training in children who are developing typically, as reflected in the training guidelines of the National Strength and Conditioning Association. for resistance training protocols, based on this evidence and appropriate to children with CP, are provided to help guide both future research and clinical practice for resistance training in children with CP.

In individuals with cerebral palsy (CP), smaller muscle and atrophy are present at young age. Many people with CP also experience a decline in gross motor function as they age, which might be explained by the loss of muscle mass. The clinical observation of muscle wasting has prompted a comparison with sarcopenia in older adults, and the term accelerated musculoskeletal ageing is often used to describe the hallmark phenotype of CP through the lifespan. However, there has been very little research emphasis on the natural history of ageing with CP and even less with respect to the determinants or prevention of muscle loss with CP.Considering the burgeoning interest in the science of muscle preservation, this paper aims to (i) describe the characteristics of accelerated musculoskeletal ageing in people with CP, (ii) describe the pathophysiology of sarcopenia and parallels with CP, and (iii) discuss possible therapeutic approaches, based on established approaches for sarcopenia.

Purpose: We investigated reliability, construct validity, and feasibility of two sprint tests for children with cerebral palsy (CP). Methods: Twenty-six children with CP participated (7–18 years of age; Gross Motor Function Classification System [GMFCS] level I or II). On different occasions, the 10 × 5-Meter Sprint Test and the Muscle Power Sprint Test were scored by different assessors. Results: Excellent interobserver reliability (intraclass correlation [ICC] = 1.0 and ICC ≥ 0.97) and test−retest reliability (ICC = 0.97 and ICC ≥ 0.97) were obtained. Scores differed significantly on both sprint tests for children classified at GMFCS level I and level II. Mean scores for feasibility ranged from 8.8 to 9.2 on a 10-cm visual analog scale (10 = the best). Conclusions: Both exercise tests are reliable and have good feasibility for children and adolescents with CP (GMFCS level I or II). Construct validity is supported for both sprint tests in children classified at GMFCS level I and level II.