Presentation Abstract

Lifespan, Longitudinal Outcomes, Exercise Guidelines for People with Cerebral Palsy

The literature on physical activity (PA) and cerebral palsy (CP) has grown exponentially over the last decade and there are now published guidelines on PA and reduction of sedentary behavior specific to children, adolescents and adults with CP (GMFCS I-III). Functional mobility appears to decline over time, particularly among children with CP who use wheelchairs. Clinical efforts have been largely directed towards preserving ambulatory status by treating the overt symptoms of CP such as pain, fatigue, gait and orthopedic issues, and spasticity. Despite the documented efficacy of these interventions to alleviate symptoms of physiologic or biomechanical dysfunction, what remains to be determined is whether such practices lead to sustainable behavior modifications and/or preservation of activity patterns across the lifespan. Future studies that are conducted in tightly controlled, clinical settings must consider the generalizability of these findings towards addressing the absence of research in implementation science that relates to sustainability and scalability, particularly among people with CP who may not have good access to community-based exercise facilities, adult populations, and individuals who use wheelchairs (GMFCS IV-V). Likewise, examining longitudinal changes in high and low responders/adherers to PA, and the association of these levels of PA for reducing/increasing the risk of obesity, diabetes and heart disease, will provide important data for future intervention research that can be more precisely tailored to the functional and behavioral levels of people with CP and their environmental context. Finally, a bottom-up approach that focuses on the needs of people with CP based on their own perspective, interests and needs (i.e., a disability studies approach) is critical for obtaining a clearer vision on how to move forward in reaching an underactive and underserved community of people with CP. Workshop organizers and participants have a unique opportunity to develop a framework and long-range plan that addresses PA translational science from efficacy to effectiveness to real-world implementation. Technology will play an important role in this effort.

About Dr. Rimmer

James Rimmer is the first Lakeshore Foundation Endowed Chair in Health Promotion and Rehabilitation Sciences at the University of Alabama at Birmingham. He is also the director of research at Lakeshore Foundation, a large 501c universally-designed wellness center for people with disabilities and chronic health conditions. He is a Professor in the School of Health Professions at the University of Alabama at Birmingham and has an adjunct faculty appointment in the Department of Physical Medicine and Rehabilitation in the School of Medicine. Dr. Rimmer is PI and director of two U.S. federally-funded centers, the National Center on Health, Physical Activity and Disability (NCHPAD, funded by the CDC since 1999), and the Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology for People with Disabilities (funded by the NIDILRR since 2002). His research interests explore the use of new and emergent technologies in developing biobehavioral and environmental strategies to promote beneficial physical activity and healthful weight management in adults with physical disabilities. Dr. Rimmer has developed a knowledge translation framework in NCHPAD that addresses the need to quickly scale up interventions that have been found successful in effectiveness trials. He is an expert in environmental barriers and facilitators of physical activity for people with disabilities. He is also the developer of the Guidelines, Recommendations, Adaptations, Including Disability (GRAIDs) framework, which is being used in several communities across the United States to promote community health inclusion in adapted evidence-based programs for people with disabilities. Dr. Rimmer’s recent work involves the creation of a telehealth rehabilitation-to-wellness onsite and online program for patients with a recently-acquired disability and new diagnoses that includes mindfulness, exercise, and nutrition.

Dr. Rimmer did not disclose any conflicts of interest for this workshop.