Peer-reviewed article
Physiological determinants of endurance capacity in individuals with cerebral palsy: a narrative review
Linnéa Corell, Nina Mosser, Sebastian Edman, Oscar Horwath, Sudarshan Dayanidhi et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This narrative review brings together research on why people with cerebral palsy often have low endurance capacity. It covers children and adults at all levels of motor function. It looks at the heart, lungs, blood and muscles. The authors conclude that central (heart and lung) and peripheral (muscle) factors together limit endurance, and that the limits are greater in people with more severe movement difficulties. They note that adapted training such as Frame Running shows promise.
Key points
- Reduced cardiorespiratory fitness is common in people with cerebral palsy.
- Autonomic dysregulation may limit heart rate responses during exercise, and lower oxygen pulse suggests limits in stroke volume and oxygen extraction.
- Restrictive ventilatory patterns, including reduced functional lung volumes, may impair exercise capacity.
- Skeletal muscle shows reduced volume, capillary density and mitochondrial function, and basic movements demand a lot of energy, which adds to fatigue and reduces physical activity.
- Impairments are more pronounced in people with greater functional limitations, and adapted training such as Frame Running shows promise.
Limitations
The review reports methodological heterogeneity across the included literature. The abstract does not describe how studies were selected, and it covers children and adults together without separating child-specific findings. It does not test any intervention, so the Frame Running comment is only suggestive.
Abstract
OBJECTIVE: To synthesize evidence on the physiological determinants of endurance capacity in individuals with cerebral palsy. DESIGN: Narrative review. SUBJECTS/PATIENTS: Children and adults with cerebral palsy across the spectrum of motor function (Gross Motor Function Classification System I-V). METHODS: Relevant literature on cardiovascular, pulmonary, haematological, and musculoskeletal determinants of endurance capacity in individuals with cerebral palsy was identified and synthesized. RESULTS: Reduced cardiorespiratory fitness is common, with autonomic dysregulation potentially constraining heart rate responses during exercise, while lower oxygen pulse suggests limitations in stroke volume and peripheral oxygen extraction. Restrictive ventilatory patterns, including reduced functional lung volumes, may further impair exercise capacity. High energetic demands during basic movements exacerbate fatigue and reduce engagement in physical activity. Skeletal muscle also exhibits structural and metabolic alterations, including reduced muscle volume, capillary density, and mitochondrial function, impairing oxygen utilization and energy production. CONCLUSION: Despite methodological heterogeneity, evidence consistently indicates that integrated central and peripheral factors constrain endurance capacity, with impairments more pronounced in individuals with greater functional limitations. Adapted training modalities, such as Frame Running, show promise in improving these outcomes. Understanding these physiological determinants is essential for developing individualized interventions to improve function, participation, health, and quality of life in individuals with cerebral palsy.