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Responses of Children with Cerebral Palsy to Arm-Crank Exercise in the Heat


Medicine & Science in Sports & Exercise: February 2004 - Volume 36 - Issue 2 - p 191-197
doi: 10.1249/01.MSS.0000113744.02922.43
CLINICAL SCIENCES: Clinically Relevant

MALTAIS, D., V. UNNITHAN, B. WILK, and O. BAR-OR. Responses of Children with Cerebral Palsy to Arm-Crank Exercise in the Heat. Med. Sci. Sports Exerc., Vol. 36, No. 2, pp. 191–197, 2004.

Purpose In response to passive heating, adults with hemispheric brain infarction demonstrate lower skin temperatures (Tsk) and higher sweating rates (SR) on the affected side. It is unknown whether children with similar conditions demonstrate a similar response and whether this response is advantageous to defending body temperature during exercise in the heat. The purpose of this study was to determine whether children with spastic cerebral palsy (CP) demonstrate less thermal strain than healthy peers during short (10 min each) bouts of arm cranking, a mode of exercise where metabolic rate can be matched between the two groups.

Methods Eleven young people (8.3–18.3 yr) with spastic CP and 11 individually matched (body size, age, and maturity) healthy controls (CON) performed 3 × 10-min arm-cranking bouts (40 rpm) in 35°C, 50% RH. Body mass, metabolic and heart rate (HR) responses, and body temperatures were periodically measured. Individuals within each CP-CON pair worked at the same intensity (0.55 ± 0.18 W·kg−1 body mass). Data were analyzed using a repeated measures ANOVA (alpha = 0.05).

Results Subjects with CP showed no difference from CON in metabolic and HR responses, or SR (as inferred from body mass changes corrected for fluid intake and output). There were also no differences between the groups in the rectal temperature change from room temperature (21–23°C). The increase in Tsk from room temperature, however, was slightly (0.6°C) but significantly lower (P < 0.0001; 95% CI = 0.5–0.7°C) in the subjects with CP compared with CON.

Conclusion Subjects with CP demonstrate thermal strain responses similar to CON during upper-body exercise at relatively low intensities for short duration in a warm climate.

1Children’s Exercise and Nutrition Centre, Department of Pediatrics, McMaster University, Hamilton, CANADA; and

2Exercise Science Department, Syracuse University, Syracuse, NY

Address for correspondence: Désirée Maltais, Children’s Exercise and Nutrition Centre, Department of Pediatrics, Chedoke Hospital Division, Hamilton, ON L8N 3Z5, Canada; E-mail:

Submitted for publication March 2003.

Accepted for publication October 2003.

©2004The American College of Sports Medicine