Physical activity in a total population of children and adolescents with cerebral palsy.
Motor severity is only one piece of the movement puzzle in CP; age, body type, and cognition shape real-life activity.
01Research in Context
What this study did
Lauruschkus et al. (2013) looked at every child and teen with cerebral palsy in Norway. They asked: who moves, where, and why?
The team linked medical records to parent surveys about school PE, leisure play, and therapy use. They checked body type, IQ, and gross-motor level.
What they found
Kids in the most severe motor level had the least free-time movement. Thin kids also moved less.
Age 7-11 year olds and heavier kids joined more school PE. Those with mental retardation got less physiotherapy.
Bottom line: motor level alone does not decide activity. Age, body shape, and thinking skills matter too.
How this fits with other research
Dudley et al. (2019) extends this idea to toddlers. They watched non-walkers at home and found no link between floor-play movement and motor scores. Both papers say: do not trust motor labels alone.
Majnemer et al. (2015) followed the same Norwegian kids two years later. Leisure dropped as they became teens. The 2013 snapshot now looks like the start of a downhill slope.
McIntyre et al. (2017) adds communication level to the mix. They show talking skill predicts enjoyment more than walking skill. Together the studies build a three-part checklist: check legs, check mouth, check mind.
Why it matters
When you write a PT or PE goal, list more than GMFCS level. Note the child’s age, weight trend, and cognitive score. Ask what they like and how they talk. Pick activities that fit today, not just the label.
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02At a glance
03Original abstract
The aims of this study were to describe the participation in physical activity of children with cerebral palsy (CP) at school and during leisure time and to identify characteristics associated with physical activity. The frequency of receiving physiotherapeutic interventions were described as a variable of interest. A total population of 364 children with verified CP aged 7-17 years living in the Skåne region in Sweden was studied using cross-sectional data from the CP follow-up programme (CPUP). Proportional odds ratios showed the most severe gross motor limitations Gross Motor Function Classification System Expanded and Revised (GMFCS-E&R) to be a characteristic for low participation in physical education at school (PE) and GMFCS-E&R level III to be a characteristic for low participation in regular physical leisure activity. The age group of 7-11 years and obesity were characteristics associated with high participation in PE, whereas thinness was associated with low participation in regular physical leisure time activities. The highest proportion of children receiving physiotherapeutic interventions was found in GMFCS-E&R level III, while mental retardation, especially if moderate or severe, proved to be an independent characteristic associated with low frequency of physiotherapeutic interventions. Gender and epilepsy did not influence the odds for participation in physical activities. Special considerations are needed when planning interventions for increased physical activity in children with CP, as the individual prerequisites differ, even among children with the same gross motor function level according to the GMFCS-E&R.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.07.005