Running Program Improves Endurance in Young CP Patients, Study Shows

A training program combining a series of running exercises using an adapted device improves cardiorespiratory endurance of adolescents and young adults with cerebral palsy, a study shows.

The study, “RaceRunning training improves stamina and promotes skeletal muscle hypertrophy in young individuals with cerebral palsy,” was published in the journal BMC Musculoskeletal Disorders.

Cerebral palsy (CP) comprises a group of neurological disorders that affect posture and restrict movement. These disorders are caused by brain lesions that occur during fetal development or infancy. As a result, these children tend to be less physically active and have worse cardiorespiratory endurance than their peers.

“Stimulating individuals with CP to regularly participate in moderate to high-intensity activities would likely increase physical fitness and thereby reduce the risk of … multiple disorders linked to premature aging and inactivity such as coronary artery disease and type 2 diabetes,” the researchers wrote.

The RaceRunner is a three-wheeled bike equipped with a saddle and chest plate, but no pedals, that can be used by CP patients with all degrees of motor impairments to practice high-intensity running exercises.

In the study, investigators at the Karolinska Institutet, in Sweden, along with colleagues set out to investigate if a 12-week RaceRunning training program could be beneficial to increase cardiorespiratory endurance, muscle tone, and joint range of motion in children and young adults with CP.

A total of 15 patients with CP — seven females and eight males, average age of 16 years — completed the 12-week RaceRunning training program, which consisted of two one-hour sessions per week. Each session included a light jog warm-up, followed by short- and long-distance sprints, technique exercises, and light jogging.

Cardiorespiratory endurance was evaluated using the six-minute RaceRunning test (6-MRT), and the rate of perceived exertion using the Borg scale (Borg-RPE). In addition, investigators measured participants’ average and maximum heart rate, thigh and lower leg muscle thickness (by ultrasound), and passive range of motion (pROM) of the hip, knee, and ankle. All parameters were assessed before and after the 12-week training program.

Cardiorespiratory endurance increased by an average of 34% by the end of the RaceRunning training period (average 6-MRT distance was 576 meters pre-training versus 723 meters post-training).

The mean average top speed also increased by 21% after the training (3.3  meters per second before the training vs. 3.7  meters per second afterwards).

No differences were found in participants’ average and maximum heart rate or in their Borg-RPE scores during the 6-MRT before and after the program.

Ultrasound imaging revealed the thickness of the lower leg muscle (the medial gastrocnemius) on the patients’ more-affected side increased by 9% during the training period. In contrast, no significant differences in muscle thickness were found for the thigh muscles or lower leg muscles on the patients’ less-affected side.

As for joint range of motion, hip flexion was found to increase on the patients’ less-affected side, while ankle dorsiflexion (the extension of the foot at the ankle) was found to decrease on the patients’ more-affected side over the course of the training period.

“Our data support the use of RaceRunning to increase cardiorespiratory fitness and promote skeletal muscle hypertrophy [enlargement] in affected limbs in individuals with CP,” the researchers wrote.

“[F]uture studies should aim at enrolling a larger number of individuals, with a more homogenous training background and include a control group,” they added.