Intensity-dependent ventilatory and cardiopulmonary patterns during exercise in trained individuals with cerebral palsy: An exploratory study

Abstract

Cerebral palsy (CP) is associated with altered exercise physiology, but it remains unclear how ventilatory and cardiopulmonary responses are expressed under high physiological demand in individuals with CP. Six athletes with CP (spastic CP: n = 3, all GMFCS III, all male, mean age 24 years; ataxic CP: n = 3, GMFCS I/I/III, two female, mean age 28 years) and three non-disabled controls (CON: two female, mean age 28 years) performed a heart rate-matched incremental rowing protocol. Oxygen uptake, minute ventilation (${\dot{V}}_E$), tidal volume (V_T), respiratory frequency and O₂ pulse were described across sitting rest and target heart rate stages of 120, 140, 160 and 180 bpm. Descriptive analyses with effect sizes were performed. Peak ${\dot{V}}_{O_2}$, recorded at the 180-bpm stage, appeared lower in CP subtypes than in CON (spastic CP: 33.9, 44.8, 31.7; ataxic CP: 35.3, 32.3, 28.3; CON: 49.3, 39.8, 48.5 mL kg⁻¹ min⁻¹). With increasing exercise intensity, O₂ pulse tended to increase progressively in CON and ataxic CP; in spastic CP, the increase appeared more attenuated. V_T appeared lower in CP than CON across all stages. At the 180-bpm stage, spastic CP showed a narrow inter-individual ${\dot{V}}_E$ range (71.4–88.3 L min⁻¹) relative to CON (90.3–138.3 L min⁻¹); ataxic CP showed wide variability (48.3–112.9 L min⁻¹). Intensity-dependent changes in O₂ pulse and ventilatory patterning appeared to differ between CP subtypes and CON, suggesting these variables may reflect subtype-specific exercise physiology in CP.