Author(s): SAVIKANGAS, T., VALADÃO, P.F.1, HAAPALA, E.A.2, JUUTINEN FINNI, T.1, Institution: UNIVERSITY OF JYVÄSKYLÄ, Country: FINLAND, Abstract-ID: 797

INTRODUCTION:
Adults with cerebral palsy (CP) have a higher risk of cardiometabolic diseases compared to the general population, but it is unknown whether this risk is elevated already in childhood and young adulthood. In addition, the evidence on the effects of exercise on cardiometabolic risk in young people with CP is limited. Therefore, we investigated the effects of a multicomponent exercise intervention on cardiometabolic risk factors in children and young adults with CP and compared this risk to typically developing (TD) controls.
METHODS:
The EXECP study included 13 males and 5 females, aged 9–22, with CP and 17 age- and sex-matched TD controls. The participants in the CP group were measured at baseline, after a 3-month control period and after the 3-month EXECP intervention. TD participants were measured twice during the control period, without participating in the intervention. The intervention consisted of supervised, progressive, and individualized strength, walking, and flexibility training 2–3 times/week, along with treadmill walking at home for 10 min/day with a focus on stepping. Body weight, whole-body fat percentage, and skeletal muscle mass index (kg/m2) were measured using bioimpedance. Systolic and diastolic blood pressure and pulse wave velocity were measured in a supine position from the left arm with an oscillometric device. Plasma LDL and HDL cholesterol, triglyceride, and glucose levels were assessed from fasting blood samples. Between-group differences in the first measurement were analyzed with independent samples t-tests and Mann-Whitney U tests. Within-group changes in cardiometabolic risk factors were analyzed using age- and sex-adjusted linear mixed-effects models, in which the participant was included as a random effect.
RESULTS:
Participants with CP had 1.0 kg/m2 lower skeletal muscle mass index (p=0.040) and tended to have 0.4 m/s higher pulse wave velocity (p=0.062) compared to TD controls. During the control period, body weight increased by 1.9 and 0.9 kg in the CP and TD groups, respectively (p≤0.05). In addition, pulse wave velocity decreased (β=-0.44, SE=0.16), and whole-body fat percentage (β=1.22, SE=0.72), skeletal muscle mass index (β=0.13, SE=0.07), and blood glucose (β=0.18, SE=0.10) tended to increase in the CP group. During the intervention, no statistically significant changes were observed in any cardiometabolic risk factor in the CP group.
CONCLUSION:
Children and young adults with CP did not differ from their TD peers for most cardiometabolic risk factors. Still, lower skeletal muscle mass index may predispose them to functional limitations and higher pulse wave velocity to elevated cardiovascular disease risk. The three-month exercise intervention focusing on strength training and gait quality was not successful in lowering cardiometabolic risk in children and young adults with CP. Longer duration and greater volume and intensity of aerobic exercise may be needed.