Differences in cardiovascular health in ambulatory persons with cerebral palsy
Patrick G. McPhee , Matthew Wong-Pack, Joyce Obeid, Maureen J. MacDonald, Brian W. Timmons , Jan Willem Gorter
School of Rehabilitation Science, McMaster University, L7T 3Z6 Hamilton, Canada. E-mail: email@example.com
Objective: To compare cardiovascular health variables and physical activity levels of adolescents and adults with cerebral palsy who are Gross Motor Func-tion Classification System (GMFCS) levels I and II.
Methods: Eleven adolescents (mean age 13.1 (standard deviation (SD) 2.1) years) and 14 adults (mean age 31.7 (SD 10.4) years)) with cerebral palsy were included, grouped by their GMFCS level (level I (n = 12); level II (n = 13)). Assessments of cardiovascular health, body composition and physical activity levels were performed. Cardiovascular variables included resting blood pressure and carotid artery intima media thickness. Body composition included height, weight, body mass index, and waist circumference. Physical activity was measured using accelerometry.
Results: Adjusting for age between GMFCS levels (GMFCS I mean 17.3 (SD 5.2); GMFCS II mean 29.3 (SD 14.1) years, p = 0.011), significant differences were evident for moderate-to-vigorous physical activity per day (GMFCS I median 45.8 (interquartile range (IQR) 32.4–75.1); GMFCS II median 16.4 (IQR 13.0, 25.0) min/day, p = 0.011), height (GMFCS I mean 1.63 (SD 0.14); GMFCS II mean 1.56 (SD 0.12) m, p = 0.010), mean arterial pressure (GMFCS I mean 84.6 (SD 7.8); GMFCS II mean 89.4 (SD 8.5) mmHg, p = 0.030), and carotid artery intima media thickness (GMFCS I mean 0.431 (SD 0.06); GMFCS II mean 0.489 (SD 0.04), p = 0.026).
Conclusion: Individuals with cerebral palsy who were GMFCS level I had lower mean arterial pressure, thinner carotid artery intima media thickness, and engaged in a greater amount of moderate-to-vigorous physical activity per day than those who were GMFCS level II. Clinicians should acknowledge that ambulatory individuals with cerebral palsy could have differing cardiovascular health profiles and should monitor these cardiovascular variables and discuss physical activity during healthcare visits, regardless of age.
Physical activity has many health benefits, one of which is the health of the heart and blood vessels. People with cerebral palsy are at risk of developing unhealthy heart and blood vessels due to limitations in mobility reducing the amount of physical activity they can perform. We studied the differences in blood vessel health between people with cerebral palsy who walk without limitations compared with those who walk with limitations. The group who walk without limitations had better measures of vessel health, such as lower blood pressure, and engaged in more physical activity than those who walk with limitations. We recommend that healthcare providers measure blood pressure and discuss physical activity with people with cerebral palsy in order to help them maintain heart and blood vessel health.
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