TY - JOUR
T1 - Maximal aerobic and anaerobic exercise responses in children with cerebral palsy.
AU - Balemans, A.C.J.
AU - van Wely, L.
AU - de Heer, S.J.
AU - van den Brink, J.
AU - de Koning, J.J.
AU - Becher, J.G.
AU - Dallmeijer, A.J.
PY - 2013
Y1 - 2013
N2 - PURPOSE: The objective of this study is to compare the maximal aerobic and anaerobic exercise responses of children with cerebral palsy (CP) by level of motor impairment and in comparison with those of typically developing children (TD). METHODS: Seventy children with CP, with varying levels of motor impairment (Gross Motor Function Classification System (GMFCS) I-III), and 31 TD performed an incremental continuous maximal aerobic exercise test and a 20-s anaerobic Wingate test on a cycle ergometer. Peak oxygen uptake (VO2peak), anaerobic threshold (AT), peak ventilation (VEpeak), peak oxygen pulse (peak O2 pulse), peak ventilatory equivalent of oxygen (peak VE/VO2) and carbon dioxide (peak VE/VCO2), peak aerobic power output (POpeak), and mean anaerobic power (P20mean) were measured. Isometric leg muscle strength was determined as a secondary outcome. RESULTS: Analysis revealed a lower VO2peak for CP (I: 35.5 ± 1.2 (SE); II: 33.9 ± 1.6; III: 29.3 ± 2.5 mL·kg·min) compared with TD (41.0 ± 1.3, P < 0.001) and a similar effect for AT (I: 19.4 ± 0.9; II: 19.2 ± 1.2; III: 15.5 ± 1.9; TD: 24.1 ± 1.0 mL·kg·min, P < 0.001). VEpeak and peak O2 pulse were also lower, whereas peak VE/VCO2 was higher in CP compared with TD (P < 0.05) and peak VE/VO2 similar between groups. All these variables showed no differences for different motor impairment levels. POpeak was lower for CP (I: 2.4 ± 0.1; II: 1.8 ± 0.1; III: 1.4 ± 0.2 W·kg) versus TD (3.0 ± 0.1, P < 0.001), together with a lower P20mean in CP (I: 4.6 ± 0.2; II: 3.3 ± 0.2; III: 2.5 ± 0.4 W·kg) versus TD (6.4 ± 0.2, P < 0.001), and both decreased significantly with increasing motor impairment. CONCLUSION: Children with CP have decreased aerobic and anaerobic exercise responses, but decreases in respiratory and aerobic exercise responses were not as severe as predicted by motor impairment. Future research should reveal the role of inactivity on the exercise responses of children with CP and possibilities for improvement through training interventions. Copyright © 2013 by the American College of Sports Medicine.
AB - PURPOSE: The objective of this study is to compare the maximal aerobic and anaerobic exercise responses of children with cerebral palsy (CP) by level of motor impairment and in comparison with those of typically developing children (TD). METHODS: Seventy children with CP, with varying levels of motor impairment (Gross Motor Function Classification System (GMFCS) I-III), and 31 TD performed an incremental continuous maximal aerobic exercise test and a 20-s anaerobic Wingate test on a cycle ergometer. Peak oxygen uptake (VO2peak), anaerobic threshold (AT), peak ventilation (VEpeak), peak oxygen pulse (peak O2 pulse), peak ventilatory equivalent of oxygen (peak VE/VO2) and carbon dioxide (peak VE/VCO2), peak aerobic power output (POpeak), and mean anaerobic power (P20mean) were measured. Isometric leg muscle strength was determined as a secondary outcome. RESULTS: Analysis revealed a lower VO2peak for CP (I: 35.5 ± 1.2 (SE); II: 33.9 ± 1.6; III: 29.3 ± 2.5 mL·kg·min) compared with TD (41.0 ± 1.3, P < 0.001) and a similar effect for AT (I: 19.4 ± 0.9; II: 19.2 ± 1.2; III: 15.5 ± 1.9; TD: 24.1 ± 1.0 mL·kg·min, P < 0.001). VEpeak and peak O2 pulse were also lower, whereas peak VE/VCO2 was higher in CP compared with TD (P < 0.05) and peak VE/VO2 similar between groups. All these variables showed no differences for different motor impairment levels. POpeak was lower for CP (I: 2.4 ± 0.1; II: 1.8 ± 0.1; III: 1.4 ± 0.2 W·kg) versus TD (3.0 ± 0.1, P < 0.001), together with a lower P20mean in CP (I: 4.6 ± 0.2; II: 3.3 ± 0.2; III: 2.5 ± 0.4 W·kg) versus TD (6.4 ± 0.2, P < 0.001), and both decreased significantly with increasing motor impairment. CONCLUSION: Children with CP have decreased aerobic and anaerobic exercise responses, but decreases in respiratory and aerobic exercise responses were not as severe as predicted by motor impairment. Future research should reveal the role of inactivity on the exercise responses of children with CP and possibilities for improvement through training interventions. Copyright © 2013 by the American College of Sports Medicine.
U2 - 10.1249/MSS.0b013e3182732b2f
DO - 10.1249/MSS.0b013e3182732b2f
M3 - Article
SN - 0195-9131
VL - 45
SP - 561
EP - 568
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 3
ER -