PMID 27900177

Research
All papers

High-intensity interval training to improve fitness in children with cerebral palsy

Lauglo R, Vik T, Lamvik T, Stensvold D, Finbråten AK, Moholdt T

Question

Can individualized high-intensity interval treadmill training improve fitness, quality of life, and body composition in children with cerebral palsy?

Summary

Children with cerebral palsy who completed an individualized supervised treadmill HIIT program improved peak oxygen uptake and submaximal exercise efficiency, with no adverse events reported, but dropout was substantial and the study used a within-subject baseline control rather than a randomized parallel control group.

Methodology

  • Children with cerebral palsy, GMFCS levels I-IV, living in Mid-Norway.
  • 20 participants.
  • Treadmill walking/running, with partial body-weight support for some participants.
  • Work intervals: Target of four 4-minute intervals, but individualized high-intensity intervals ranged from 1.5 to 4 minutes.
  • Recovery: Active breaks around 70% HRmax, shortened when work intervals were shortened.
  • Intensity: High-intensity work above 85% HRmax.
  • 5-10 minute warm-up plus intervals and active breaks.
  • 2-4 sessions per week.
  • Up to 24 sessions; completers trained over 5-12 weeks.
  • Baseline-control pilot intervention with T0 enrollment, T1 after a 4-week regular-activity baseline period, and T2 after HIIT.
  • VO2peak, Submaximal oxygen cost and heart rate, Quality of life, and Body composition were tracked.

Outcomes

VO2peak

VO2peak increased after HIT, with no comparable change during the baseline period.

VO2peak increased 10%, from 37.3 (31.0-40.1) to 41.0 (36.6-48.5) mL/kg/min from T1 to T2; p < 0.01.

Improved

Submaximal exercise response

Relative submaximal oxygen cost and submaximal HR decreased after training.

Percent VO2peak decreased 48.8 to 39.4, p < 0.01; submaximal HR decreased 127 to 117 bpm, p = 0.02.

Improved

Quality of life

Parent-reported quality of life improved, but child-reported quality of life did not significantly change.

Parent total score p = 0.04 over time and self-esteem p = 0.02; child-reported total p = 0.10.

Mixed

Body composition

No clear body composition changes were detected.

DXA body composition variables showed no significant changes; lean mass trend p = 0.05.

No clear change

Insights

  • Individualization and physical support can make interval training feasible for children with motor impairments.
  • High intensity may be effective but motivational burden and dropout are important design constraints.
  • For special pediatric populations, supervised clinical delivery is central to safe translation.

Limitations

  • Small pilot sample and high dropout.
  • No randomized parallel control group.
  • Only children able to perform testing/training were included, limiting generalizability across cerebral palsy severity.
  • Only eight participants completed VO2peak testing to standard criteria.
  • Support bars and partial body-weight support may have affected VO2peak validity.
  • Parent-reported quality-of-life outcomes may be biased and multiple comparisons were not adjusted.

Safety

  • No adverse events were registered during exercise testing or training.
  • Six of 20 included participants dropped out; the discussion attributed four withdrawals to lack of motivation and the strenuous regime.
  • Partial body-weight support was used for four children to facilitate training.