Telehealth Maximal-intensity Interval Training Safely Improves Cardiorespiratory Fitness Among Children with Cerebral Palsy: Preliminary Findings

Research Objectives: To investigate the preliminary efficacy of a maximal-intensity arm exercise program on cardiorespiratory fitness and cardiometabolic health among children with cerebral palsy. A secondary objective is to evaluate the feasibility of the program via safety and adherence.

Design: Randomized controlled trial with a 2-armed parallel group design, which aims to recruit 50 children with cerebral palsy (aged 6-17 years of age). Participants are randomized to either an immediate start (IS) 12-week sprint-intensity exercise program or a waitlist control group that continues habitual activity for 12 weeks.

Setting: Home-exercise and recruitment from the Division of Pediatric Rehabilitation Medicine clinics at the Children's Hospital of Alabama.

Participants: A total of 25 participants were enrolled: 3 participants dropped out; 7, are ongoing; 12, completed.

Interventions: The program included 3 supervised exercise sessions conducted at home, monitored through a web-based platform with videoconference and heart rate monitoring features. Exercises included adapted movements with music and child appropriate themes (e.g., superheroes and pop culture), guided by pre-recorded videos on YouTube.

Main Outcome Measures: Outcomes were measured at pre- and post-intervention (weeks 0 and 13, respectively). Peak oxygen consumption (pVO2; primary outcome) was measured by portable metabolic cart during a graded exercise test. Secondary outcomes included body composition (measured by dual x-ray absorptiometry) and cardiometabolic profile (measured by blood spot test). Feasibility was evaluated several process metrics.

Results: From completers or those in the IS group (n=12), exercise session attendance was 92% (n=238/258 sessions; n=12), and the exercise intensity achieved was a score of 6.7 (hard to very hard intensity) on the 0-10 Borg rating of perceived exertion scale. No adverse events or problems were identified or reported. Repeated measures ANOVA demonstrated a statistically significant group difference in the rate of change in pVO2 measured at pre and post, in favor of the IS group (df=12, F=11.9, p-value=0.005). Mean change in pVO2 for the IS group was 1.7 ± 1.9 ml/min/kg (95%CI=0-3.4 ml/min/kg; n=7) and -0.52 ± 3.2 ml/min/kg (95%CI=-3.5-2.5 ml/min/kg; n=7). No statistically significant changes were observed among other variables.

Conclusions: Preliminary analysis of this ongoing trial suggests improvements in cardiorespiratory capacity following a telehealth sprint-intensity arm exercise program. Findings demonstrate that the program is safe and well attended by children with cerebral palsy. Further analysis upon completion of the trial is necessary to enhance the strength of the presented findings.

Author(s) Disclosures: None declared.