Community-based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review.
Prue Morgan, Stacey Cleary, Iain Dutia and 2 others
PMID 37032538WHAT IT FOUND
Community exercise is safe for people with severe cerebral palsy.
Across 17 studies, serious injuries were rare and dropouts low. Most pain or fatigue was minor and resolved quickly, suggesting therapists can confidently prescribe activity in community settings.
Key findings
01Serious adverse events and injuries were rare, with less than 2% of participants withdrawing or stopping exercise temporarily due to pain.
02Participants attended approximately 80% or more of scheduled sessions, and attrition was generally low.
03Common side effects were minor muscle soreness and fatigue, which resolved quickly without medical review and did not prevent continued participation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Many participants with intellectual disabilities, epilepsy, or severe communication impairments were excluded from the original studies, limiting generalizability to the whole GMFCS IV-V population. The review relied on 17 studies with small sample sizes and heterogeneous designs, including several single-subject studies. The role of supervision was not isolated; it is unclear if the low adverse event rate is due to the exercise itself or the constant professional oversight. Only time-limited programs were evaluated, so safety over the long term or lifespan is unknown.
Declared interests
Funded by the National Health and Medical Research Council. No other conflicts of interest reported.
The easy way to misread this
Do not assume these safety findings apply to patients with uncontrolled epilepsy or severe intellectual disabilities, as they were largely excluded from the reviewed studies. Additionally, the safety observed occurred under supervision; the risk level for unsupervised community exercise remains unknown.