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The clinimetric properties of aerobic and anaerobic fitness measures in adults with cerebral palsy: A systematic review of the literature |
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| Institution: | 1. Nemours Biomedical Research, The duPont Hospital for Children, Wilmington, DE, USA;2. Division of Physical Therapy, Center for Human Movement Science, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;3. Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;4. Franciscan''s Hospital for Children, Boston, MA, USA;5. Department of Physical Therapy and Rehabilitation Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA;6. Pediatrics/Genetics and Developmental Medicine, University of Washington, Seattle, WA, USA;7. Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland, Queensland, QLD, Australia;1. Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA;2. Music Engineering Technology Program, University of Miami Frost School of Music, Coral Gables, FL, USA;3. Neil Spielholz Functional Outcomes Research & Evaluation Center, University of Miami, Coral Gables, FL, USA;1. Institute of Clinical Physiology (IFC), CNR, Pisa, Italy;2. Department of Teaching and Learning (DFA) – University School of Applied Sciences and Arts of Southern Switzerland (SUPSI), Locarno, Switzerland;3. Service of Child Neuropsychiatry, Azienda Sanitaria Locale 4, Lanusei, Italy;4. Istituto Santo Stefano, Porto Potenza Picena (MC), Italy;1. Division of Pediatric Neurosurgery, Texas Children''s Hospital, Houston, Texas, USA;2. Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA;3. Division of Pediatric Neurosurgery, Riley Hospital for Children, Indianapolis, Indiana, USA;4. Department of Neurosurgery, Goodman Campbell Brain and Spine, Indiana University, Indianapolis, Indiana, USA;1. Department of Surgery, Cleveland Clinic, Cleveland, OH, USA;2. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA;3. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA;4. Department of Surgery, University of Verona, Verona, Italy;5. Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania;6. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal;7. Department of Surgery, Ospedale San Raffaele, Milan, Italy;8. Department of Surgery, Emory University, Atlanta, GA, USA;9. Department of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia;10. Department of Surgery, University of Virginia, Charlottesville, VA, USA;11. Eastern Hepatobiliary Surgery Hospital, Shanghai, China;12. Department of Surgery, Stanford University, Stanford, CA, USA;13. Department of Hepatobiliopancreatic Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, Clichy, France;14. Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, Canada;15. Department of Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands;16. Gastroenterological Surgery Division, Yokohama City University School of Medicine, Yokohama, Japan;1. Laboratoire d’Analyse du Mouvement, Pôle hospitalo-Universitaire de Médecine Physique et de Réadaptation, CHU de Nantes, 85 rue Saint Jacques, 44093 Nantes cedex, France;2. Université de Brest Inserm UMR 1101, Laboratoire de Traitement de l''Information Médicale, SFR ScInBioS, 5 avenue Foch, 29609 Brest, France;3. College of Health & Social Care, University of Salford, Allerton Building, Frederick Road Campus, Salford M6 6PU, United Kingdom;4. Service de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire de Brest, 5 avenue Foch, 29609 Brest, France |
| Abstract: | ObjectiveTo analyze the clinimetric properties of maximal aerobic and anaerobic fitness measurement protocols in adults with cerebral palsy (CP).Data SourcesA systematic search through March 2015 of databases PubMed, Embase, SPORTDiscus and PsycINFO was performed with medical subject heading terms for ‘cerebral palsy’ combined with search terms adults or adolescents and multiple text words for fitness and exercise tests that yielded 864 articles.Study SelectionAbstracts were screened by two reviewers to identify use of maximal fitness measurements in adolescents (14–18 yrs) or adults (>18 yrs) with CP of all abilities. Ninety-four articles were reviewed. No studies of adolescent (14–18 yrs) qualified. Eight articles reported clinimetric properties for adults with CP who walk or propel a wheelchair independently. Five articles reported on aerobic capacity, one reported on anaerobic capacity and two reported on both.Data ExtractionMethodological quality of the studies was rated using portions of the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) checklist. Quality of the measurement protocols was evaluated based on statistical strength of the clinimetrics. Synthesis of the overall evidence was based on the Cochrane review group guidelines which combine methodological quality and statistical strength.Data SynthesisEight articles reported on 4 aerobic and 1 anaerobic protocols. Overall synthesis revealed that for ambulatory adults with CP there is (i) moderate evidence for good reliability and good construct validity of maximal aerobic and anaerobic cycle tests, (ii) moderate evidence for good criterion validity of sub-maximal aerobic cycle tests, and (iii) strong evidence for poor criterion validity of the six-minute walk test as a maximal aerobic test. And for adults who propel a wheelchair there is limited evidence of good reliability for maximal aerobic wheelchair ergometer tests.ConclusionsLimited quality research exists on the clinimetric properties of aerobic and anaerobic capacity measures for adults with CP who have independent mobility. Quality aerobic and anaerobic measures for adults with more severe mobility impairments are absent. |
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