title: Impact of cerebral palsy on health-related physical fitness in adults: systematic review.
abstract: OBJECTIVE
  To conduct a systematic review of the impact of cerebral palsy (CP) on the level of health-related physical fitness (body composition, cardiorespiratory endurance, flexibility, muscular endurance, and strength) in adults with CP compared with able-bodied adults.
  
  
  METHODS
  The Cochrane Library, MEDLINE, CINAHL, EMBASE, and PEDro were searched up to December 2010 for relevant comparative studies.
  
  
  METHODS
  Two reviewers independently applied the inclusion criteria (adults, comparative design, components of physical fitness) to select potential relevant studies.
  
  
  METHODS
  Two reviewers independently extracted the data and assessed the methodological quality. A consensus method was used to solve disagreements.
  
  
  RESULTS
  Pooling data was not possible, but a best-evidence synthesis was conducted. Also, a description of the level of health-related physical fitness in CP was given (expressed as a percentage of able-bodied controls). Nine case-control studies were included (average age ± SD of subjects with CP, 21±3y): 3 investigated body composition; 5, cardiorespiratory endurance; 3, muscular strength; and 1, muscular endurance. Two of the studies investigated multiple fitness components. No studies on flexibility were found. Muscular strength (34%-60%), muscular endurance (27%-52%), and cardiorespiratory endurance (14%) showed significantly lower values in adults with CP compared with able-bodied controls. Studies on body composition reported conflicting results on the impact of CP.
  
  
  CONCLUSIONS
  The results of this review point to a reduction in 3 components of health-related physical fitness in young adults with CP compared with controls: muscular strength, muscular endurance, and cardiorespiratory endurance. However, the level of evidence varies from moderate (muscular strength) to limited (muscular endurance and cardiorespiratory endurance). Additional studies of high methodological quality are recommended before firm conclusions can be made.
authors.affiliation: Department of Rehabilitation Medicine and Physical Therapy, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Hombergen
authors.forename: Bionka M
authors.initials: BM
authors.lastname: Huisstede
authors.forename: Marjolein F
authors.initials: MF
authors.lastname: Streur
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.forename: Jorrit
authors.initials: J
authors.lastname: Slaman
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Bussmann
authors.forename: Rita J
authors.initials: RJ
authors.lastname: van den Berg-Emons
mesh_terms: D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology*; D017079:Exercise Tolerance; D006801:Humans; D018763:Muscle Fatigue; D053580:Muscle Strength; D010809:Physical Fitness / Q000502:physiology*