Purpose: Participating in physical activity may benefit health-related outcomes for adults with cerebral palsy (CP). The aim of this review is to provide a synthesis of the evidence from both qualitative and quantitative studies on the impact of physical activity and exercise interventions in adults with CP.
Methods: Literature searches were conducted from inception to November 2023 in nine electronic databases. A meta-analysis was carried out to evaluate the efficacy of the interventions on walking speed related outcomes and muscle strength.
Results: Twenty-two studies met the inclusion criteria. The interventions of the nine studies included in the meta-analysis did not improve walking speed over a distance of 10 m (SMD = -0.03, 95% CI: -0.34-0.40, p = 0.88, I2 = 0%) or endurance (distance covered in 2 or 6 min) (SMD = 0.25, 95% CI: -0.10-0.59, p = 0.16, I2 = 0%), but there was an improvement in lower limb muscle strength in favour of the experimental groups (SMD = 0.59, 95% CI: 0.19-0.99, p = 0.004, I2 = 20%). Only a few studies reported on psychosocial outcomes, quality of life, or intervention sustainability.
Discussion and conclusions: Further research is needed to explore the impact on psychosocial outcomes and quality of life in adults with CP and the sustainability of physical activity participation.
Keywords: Cerebral palsy; adults; exercise; meta-analysis; physical activity; sustainability; systematic review.
Meta-analyses identified improvement in lower limb muscle strength, but not in walking related outcomes in adults with cerebral palsy.Practitioners should be aware that enjoyment and confidence are key themes associated with a positive experience of physical activity participation.Rehabilitation should include psychosocial and participation outcomes as these are of critical importance for long-term participation.Practitioners should refer their clients to physical activity and exercise opportunities that are accessible and sustainable long-term.