Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
The Rehabilitation Science Program, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.
Dev Med Child Neurol. 2021 Feb;63(2):162-171. doi: 10.1111/dmcn.14751. Epub 2020 Nov 25.
AIM: To summarize current evidence on the effects and reach of leisure-time physical activity (LTPA) interventions among children and adults with cerebral palsy (CP). METHOD: Systematic searches were conducted in PubMed, CINAHL, and Google Scholar to identify randomized controlled trials (RCTs) of LTPA interventions in CP. Data from eligible studies were extracted for qualitative synthesis. RESULTS: Forty-nine studies enrolled a total of 1513 participants (mean [SD] age 13y [7y], range 5-43y; 818 males, 655 females, 40 not reported) and primarily included ambulatory children. RCTs underrepresented adults and people in Gross Motor Function Classification System (GMFCS) levels IV and V. Forty-one studies reported at least one favorable benefit from LTPA. Benefits included improvements to musculoskeletal strength, cardiorespiratory fitness, quality of life, spasticity, participation, and core aspects of physical function. Regarding reach, only 34% of people that were contacted to participate enrolled within a study. A smaller percentage of participants dropped out from intervention (8%) and follow-up periods (3%). INTERPRETATION: Study findings highlight effective interventions to improve health, fitness, and function. To enhance the reach and generalizability of LTPA trials for CP, future studies should examine how to increase study sample sizes and aim to include a better representation of adults and people in GMFCS levels IV and V. WHAT THIS PAPER ADDS: People with cerebral palsy (CP) may experience improvements in health, fitness, and physical function from leisure-time physical activity (LTPA) interventions. Effective interventions include exercise training, active video games, recreation activities, behavioral coaching, and motor skills training. Interventions that incorporate telehealth technology, behavioral coaching, and community resources may enhance LTPA. Interventions primarily include children in Gross Motor Functional Classification System (GMFCS) levels I to III. Adults, wheelchair users, and those in GMFCS levels IV and V are underrepresented.
目的：总结针对脑瘫（CP）患儿和成人的休闲时间体力活动（LTPA）干预措施的效果和范围的现有证据。
方法：在 PubMed、CINAHL 和 Google Scholar 中进行系统检索，以确定 CP 患者的 LTPA 干预措施的随机对照试验（RCT）。提取合格研究的数据进行定性综合。
结果：49 项研究共纳入 1513 名参与者（平均[标准差]年龄 13 岁[7 岁]，范围 5-43 岁；818 名男性，655 名女性，40 名未报告），主要包括可活动的儿童。RCT 代表性不足，没有纳入 GMFCS 水平 IV 和 V 的成年人和患者。41 项研究报告了 LTPA 至少有一项有益效果。这些益处包括肌肉骨骼力量、心肺健康、生活质量、痉挛、参与度和身体功能的核心方面的改善。关于覆盖范围，只有 34%的受邀参与者在研究中注册。从干预（8%）和随访（3%）中退出的参与者比例较小。
解释：研究结果突出了有效的干预措施，可以改善健康、健身和功能。为了提高 CP 的 LTPA 试验的范围和推广性，未来的研究应研究如何增加研究样本量，并旨在更好地代表 GMFCS 水平 IV 和 V 的成年人和患者。
本文增添的内容：脑瘫（CP）患者可能会从休闲时间体力活动（LTPA）干预中获益，包括健康、健身和身体功能的改善。有效的干预措施包括运动训练、积极的视频游戏、娱乐活动、行为指导和运动技能训练。采用远程医疗技术、行为指导和社区资源的干预措施可能会增强 LTPA。干预措施主要包括 GMFCS 水平 I 至 III 的儿童。成年人、轮椅使用者和 GMFCS 水平 IV 和 V 的患者代表性不足。
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