CP Patients with Walking Difficulties Show Poorer Cardiovascular Health, Study Shows

People with cerebral palsy who have walking difficulties are at risk of developing cardiovascular disorders and may be more vulnerable to heart problems, a study finds.

Doctors should be aware of these problems and provide adequate care to these patients by monitoring cardiovascular parameters, such as blood pressure, and discussing physical activity, regardless of patients’ age and ability to walk, researchers recommend.

The study, “Differences in cardiovascular health in ambulatory persons with cerebral palsy,” was published in the Journal of Rehabilitation Medicine.

Low levels of physical activity are associated with a higher likelihood of problems in the heart and blood vessels, or cardiovascular disorders. Ability to walk seems to make a difference, as those unable to do so seem to be more susceptible to these problems.

Prior studies have associated cerebral palsy (CP) with a greater propensity for cardiovascular and related diseases, including diabetes, high blood pressure, and stroke, with this risk becoming worse later in life.

To evaluate how much walking ability influences cardiovascular risk, researchers compared cardiovascular health in young people and adults with cerebral palsy who walked with no limitations to those with gait difficulties.

The study included 11 adolescents (mean age 13.1) and 14 adults (mean age 31.7) with cerebral palsy who were participating in Stay-FIT, a Canadian program to understand and encourage physical health in people with CP.

Participants were divided in two groups based on their gross motor skills, as determined by the GMFCS-E&R, a classification system for young people with cerebral palsy.

Those with skills categorizing as level I (12 participants) were able to walk and climb stairs without assistance, while participants on level II (13 participants) could walk in most settings but would need additional aid such as a hand-held device, stair railings, or a wheelchair under circumstances such as an uneven floor or for traveling long distances.

Participants’ health status was evaluated through their resting blood pressure, artery wall thickness, and body composition. Their physical activity was determined using an accelerometer, a wearable device that recorded their daily activity.

Results confirmed that individuals who walked without limitations (level I) had better measures of vessel health and were physically more active than those with more difficulty walking (level II). Differences were evident for mean blood pressure and carotid artery wall thickening, which were both lower among fully independent walkers.

Accordingly, this group also engaged in greater amounts of moderate to vigorous physical activity each day compared with participants on GMFCS level II.

In this latter group, a combination of elevated blood pressure, thickened — and potentially narrower — arteries, and lower physical activity could put them at increased risk of developing cardiovascular diseases.

Based on these findings, researchers say clinicians should be aware that individuals with cerebral palsy who are unable to walk may differ in their cardiovascular health.

They recommend doctors should monitor cardiovascular parameters, such as blood pressure, “and discuss physical activity with people with cerebral palsy in order to help them maintain heart and blood vessel health,” they stated.