Physical Strain During Walking in Adults With Cerebral Palsy: A Construct Validity Study.

The authors did not adjust for potential confounders, so what is reported are associations, not causes. The sample was unevenly spread across walking ability: 64 people at GMFCS level I, 22 at level II and only 8 at level III. The findings describe people with better gross motor function best, and the small level III group makes the level II versus level III comparison unreliable. Seven of the eight people at level III held the handrail while walking on the treadmill, compared with 2 of 22 at level II. Handrail support lowers oxygen use, which may have shrunk the difference between those two groups. People at level III used walking aids in daily life but not during the treadmill test, so the test conditions did not match how they actually walk. Everyone in the study could walk and no one had an intellectual disability, so adults with CP who use a wheelchair or have cognitive impairments are not represented. Physical strain was measured on a treadmill rather than in daily life, and the authors say its repeatability and ability to detect change still need to be tested.

The authors state that they have no financial or nonfinancial disclosures to make in relation to this project. The text supplied contains no funding statement.

Do not read the near-normal fitness numbers as a sign these adults walk without effort. At their own preferred pace they used a median 50% of their maximal aerobic capacity, and even the highest-functioning group used 45%. This is a one-off measurement study, so it also says nothing about whether training or any other treatment changes that strain.