PTOTSLPCohortDevelopmental medicine and child neurology2026

Disproportional ventilatory response to incremental exercise in individuals with cerebral palsy.

Linnéa Corell, Emma Hjalmarsson, Rodrigo Fernandez-Gonzalo and 12 others

PMID 41549373

WHAT IT FOUND

Individuals with cerebral palsy breathe much faster during exercise than typically developing people, even at lower heart rates.

This is likely due to an inability to take deeper breaths rather than metabolic stress. Therapists should monitor respiratory rate, not just heart rate, to gauge exertion.

Key findings

01Individuals with cerebral palsy had a disproportionately high respiratory frequency compared to typically developing individuals when adjusted for cardiovascular intensity, despite working at lower heart rates.

02This altered breathing pattern was associated with lower tidal volumes and reduced lung capacity (FVC and FEV1) at rest and during exercise.

03Metabolic markers like lactate and CO2 did not explain the high breathing rate, suggesting the response is driven by mechanical or behavioral factors rather than metabolic need.

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

The sample size was small (16 with CP, 30 TD). Participants with CP were mostly GMFCS levels II-IV and experienced in frame running, so results may not generalize to those with more severe motor impairments or no frame running experience. Dynamic spirometry and ECG data were collected one year after the exercise tests, which could introduce variability. The formula used to estimate maximum heart rate (220-age) may not be accurate for individuals with CP. Face masks used for spirometry in some CP participants may have slightly underestimated lung volumes compared to mouthpieces used for TD participants.

Declared interests

The authors declared no conflicts of interest. Funding was provided by several foundations including Norrbacka-Eugenia Stiftelsen, Stiftelsen Sunnerdahls Handikappfond, and others.

The easy way to misread this

Do not assume that a low heart rate means the patient is not working hard. Individuals with CP may have high respiratory rates and perceived exertion even when their heart rate and metabolic markers are lower than typical, due to ventilatory limitations.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →