Aerobic fitness in children with cerebral palsy compared to typically developing peers: a systematic review and meta-analysis

Abstract

In the public health domain, aerobic fitness is an important predictor of both health and disease. To determine aerobic fitness in children with cerebral palsy (CP) compared to typically developing (TD) peers measured with a maximal exercise test. A systematic literature search was conducted in PubMed (MEDLINE), PsycArticles, PsycInfo, CINAHL, and SPORTDiscus (EBSCO). Original studies that reported findings on aerobic fitness expressed as peak oxygen uptake (VO2peak) during a maximal exercise test measured with a gas analysis system, in children with CP, aged 18 years or younger, were included. VO2peak values were pooled, using the generic inverse variance method, for type of maximal exercise test, Gross Motor Function Classification System (GMFCS) level, distribution of CP, and sex. Thirty-six studies with a total of 510 children with CP (GMFCS I-IV) and 173 TD peers were included. VO2peak was measured using cycle ergometer test (n = 16), treadmill exercise test (n = 13), arm crank ergometer test (n = 6), shuttle run test (n = 3), and shuttle ride test (n = 1). The overall pooled VO2peak in children with CP was 32.84 mL/kg/min (SE 1.28) and 45.02 mL/kg/min (SE 1.32) in TD peers, with a difference between CP and TD of -12.17 mL/kg/min (95 % CI: -16.70, -7.64). Subgroup analyses revealed that aerobic fitness was most compromised in children at higher GMFCS levels and boys with CP. Aerobic fitness is severely compromised in children with CP. Promoting a healthy lifestyle and increasing participation in physical activities for young people with CP is recommended. The study protocol was prospectively registered in the PROSPERO registry with reference number CRD42021292879.