Community-based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review

It is important for people of all ages and mobility levels to have access to safe physical activities. Being physically active reduces the chances of developing additional illnesses as we get older, and helps our bodies and minds to feel well.

Young people with complex forms of cerebral palsy (CP) are more likely to have long-term health issues because they don't participate in physical activity very much. They want to be more involved in community physical activities, but face many barriers. It is important to find suitable physical activity programs they can join, to address their health needs.

We conducted a review of exercise programs for teenagers and young adults with complex forms of CP (GMFCS levels IV and V). Our goal was to identify ways that exercise programs were delivered to this population (‘implementation strategies’) and assess the safety and any risks of the programs.

We identified 17 studies that included 160 teenagers and young adults with complex CP. Exercise programs were held in schools, homes, gyms, and swimming pools. The programs included activities such as cycling, walking on treadmills, swimming, weightlifting, and dancing. There were high participation rates, and only a few people experienced minor soreness or fatigue. Serious events related to exercising were rare, with only 4 out of 160 participants (<2%) reporting them. Across all the studies, only three participants withdrew from a program, and one participant needed to take a break from exercising for a short time.

Implementation strategies for these exercise programs included pre-exercise screening, using adapted equipment, offering familiarisation sessions, supervision, physical assistance, and regular monitoring of participants' physical wellbeing.

This review showed that for most teenagers and adults with complex CP, it is safe to participate in physical activity programs in the community. They generally do not experience significant post-exercise pain or fatigue, nor face serious negative events. Young people with CP should be encouraged to explore and participate in community physical activities that interest them.