Muscle-tendon pathology and metabolic dysregulation in CP

Background Spastic cerebral palsy (CP) is the most common cause of physical impairment in children. Although the initial brain damage does not get worse during life, dramatic changes occur in the individuals musculoskeletal system and deteriorate further with age. In addition, people with CP are less physically active than healthy individuals. Moreover, severely affected individuals, who are largely dependent on wheelchairs, move the least. It is believed that especially the latter group is severely affected by reduced muscle size and has low levels of muscle strength and fitness. Furthermore, metabolic problems and chronic inflammation may also be present in this group. Whether this is indeed the case and which role physical inactivity and muscle changes play, has not yet been clarified. In addition, it is not known whether their tissues and organs can still adapt to health-promoting physical activities. Goals With this project we aim to get a better understanding of the muscle and tendon changes of moderately to severely affected young people with CP as well as their risk of cardiovascular disease and chronic inflammation. In addition, we investigate whether there is a relationship between the extent of CP and inactivity, muscle function, cardiometabolic risk factors, and inflammation. With this project, we also want to gain knowledge about the potential for physical adaptations in the target group. Methods The examination parameters will be measured in adolescents and young adults with moderate to severe CP and compared to a group with mild CP as well as typically developed persons of the same age. In addition, they will participate in a 12-week fitness intervention with special tricycles (so-called Frame Runners). The examination parameters, for example, muscle size, will be analyzed with ultrasound, near-infrared spectroscopy, blood analyses, and spiroergometry. Level of innovation This project is the first to perform a holistic evaluation of pathological changes in young people with moderate to severe spastic CP. We focus on a large group of people with severe CP that is, due to its symptoms, difficult to access and therefore has not gotten much attention so far. By using the Frame Runner in combination with innovative measurement technology, new insights can be gained that are important for the future therapy. Moreover, the Frame Runners are used for the first time in Styria for measurements and training of physical fitness. Researchers involved Annika Kruse is a movement and training scientist and is specialized mainly in CP as well as the testing of training and therapy effects. Her project is supported by experts in the fields of muscle biomechanics (M. Tilp), exercise physiology, neuropediatrics and CP (F. von Walden, M. Svehlik), and physical activity (M. van Poppel).