{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T01:06:57Z","timestamp":1776560817200,"version":"3.51.2"},"reference-count":77,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Gillette Children\u2019s Foundation Long-Term Outcomes Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Impairments associated with cerebral palsy (CP) can affect gait quality and limit activity and participation. The purpose of this study was to quantify (1) which of 6 factors (pain, weakness, endurance, mental ability, safety concerns, balance) were perceived to limit walking ability the most in individuals with CP and (2) whether age or Gross Motor Function Classification System (GMFCS) level is related to that perception.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study queried data from a gait laboratory database. Perceived walking limitation was quantified using a 5-point Likert scale (\u201cnever\u201d to \u201call of the time\u201d). Included were 1566 children and adults (mean age\u00a0=\u00a010.9 y [SD\u00a0=\u00a06.8]; range\u00a0=\u00a03.0\u201372.1 y) with CP (GMFCS level I: 502; II: 564; III: 433; IV: 67).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients or caregivers perceived balance to limit walking ability to the greatest extent, followed by endurance, weakness, safety, mental ability, and pain. Balance was perceived to always limit walking ability in 8%, 22%, 30%, and 34% of individuals in GMFCS levels I through IV, respectively. Endurance was perceived to always limit walking ability in 5%, 13%, 13%, and 27% of individuals in GMFCS levels I through IV, respectively. There were minor differences in the perceived extent of limitation caused by the factors by GMFCS level. Only weak associations between age and pain, mental ability, safety, and balance were observed (Spearman rho\u00a0=\u00a0\u22120.13 to 0.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients or caregivers perceived decreased balance and endurance to most strongly limit walking ability. Efforts should be made to clinically track how both perceived and objective measures of these limiting factors change with age and intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Impact<\/jats:title><jats:p>Following a patient- and family-centered care model, therapy that places greater emphasis on balance and cardiovascular endurance may have the greatest effect on walking ability for individuals with CP. Future research should quantify which therapeutic, surgical, and pharmacologic interventions minimize these impairments and optimize activity and participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay Summary<\/jats:title><jats:p>Balance and endurance are perceived to be the greatest factors limiting walking in people with CP. If you have CP, your physical therapist might emphasize balance and cardiovascular endurance to improve your walking ability.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ptj\/pzab102","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T20:16:30Z","timestamp":1616530590000},"source":"Crossref","is-referenced-by-count":11,"title":["Perceived Limitations of Walking in Individuals With Cerebral Palsy"],"prefix":"10.1093","volume":"101","author":[{"given":"Jennifer A","family":"Nelson","sequence":"first","affiliation":[{"name":"Center for Gait and Motion Analysis , Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth R","family":"Boyer","sequence":"additional","affiliation":[{"name":"Center for Gait and Motion Analysis , Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA"},{"name":"Department of Orthopedic Surgery, University of Minnesota \u2013 Twin Cities , Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"2023011802392140900_ref1","first-page":"1","article-title":"Cerebral palsy","volume":"2","author":"Graham","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2023011802392140900_ref2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/PEP.0000000000000221","article-title":"Description of primary and secondary impairments in young children with cerebral palsy","volume":"28","author":"Jeffries","year":"2016","journal-title":"Pediatr Phys Ther"},{"key":"2023011802392140900_ref3","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s00381-007-0378-6","article-title":"Orthopedic management of spasticity in cerebral palsy","volume":"23","author":"Novacheck","year":"2007","journal-title":"Childs Nerv Syst"},{"key":"2023011802392140900_ref4","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.clinph.2010.03.010","article-title":"Developmental changes in somatosensory processing in cerebral palsy and healthy individuals","volume":"121","author":"Riquelme","year":"2010","journal-title":"Clin Neurophysiol"},{"key":"2023011802392140900_ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12883-019-1597-7","article-title":"Pain in children and adolescents with cerebral palsy\u2014a cross-sectional register study of 3545 individuals","volume":"20","author":"Eriksson","year":"2020","journal-title":"BMC Neurol"},{"key":"2023011802392140900_ref6","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1080\/16501970310018305","article-title":"Musculoskeletal pain in adults with cerebral palsy compared with the general population","volume":"36","author":"Jahnsen","year":"2004","journal-title":"J Rehabil Med"},{"key":"2023011802392140900_ref7","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/j.1526-4637.2011.01094.x","article-title":"Age-related changes of pain experience in cerebral palsy and healthy individuals","volume":"12","author":"Riquelme","year":"2011","journal-title":"Pain Med"},{"key":"2023011802392140900_ref8","doi-asserted-by":"publisher","first-page":"101359","DOI":"10.1016\/j.rehab.2019.12.011","article-title":"Pain in adults with cerebral palsy: a systematic review and meta-analysis of individual participant data","volume":"64","author":"Slot","year":"2021","journal-title":"Ann Phys Rehabil Med"},{"key":"2023011802392140900_ref9","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano","year":"1997","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref10","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/j.1469-8749.2004.tb01021.x","article-title":"Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities","volume":"46","author":"\u00d8stensj\u00f8","year":"2004","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref11","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1093\/ptj\/pzy132","article-title":"Developmental trajectories for the early clinical assessment of balance by gross motor function classification system level for children with cerebral palsy","volume":"99","author":"Laforme Fiss","year":"2019","journal-title":"Phys Ther"},{"key":"2023011802392140900_ref12","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1469-8749.2004.tb00431.x","article-title":"Energy cost of walking in children with cerebral palsy: relation to the gross motor function classification system","volume":"47","author":"Johnston","year":"2004","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1741-7015-7-65","article-title":"Development of lower limb range of motion from early childhood to adolescence in cerebral palsy: a population-based study","volume":"7","author":"Nordmark","year":"2009","journal-title":"BMC Med"},{"key":"2023011802392140900_ref14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1615\/CritRevPhysRehabilMed.v23.i1-4.10","article-title":"Assessment of strength and function in ambulatory children with cerebral palsy by GMFCS level and age: a cross-sectional study","volume":"23","author":"Hassani","year":"2011","journal-title":"Crit Rev Phys Rehabil Med"},{"key":"2023011802392140900_ref15","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/j.1469-8749.2008.03186.x","article-title":"Selective control assessment of the lower extremity (SCALE): development, validation, and interrater reliability of a clinical tool for patients with cerebral palsy","volume":"51","author":"Fowler","year":"2009","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref16","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.gaitpost.2008.05.004","article-title":"Walking ability is related to muscle strength in children with cerebral palsy","volume":"28","author":"Eek","year":"2008","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref17","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ridd.2014.09.016","article-title":"Capacity of adolescents with cerebral palsy on paediatric balance scale and Berg balance scale","volume":"36","author":"Jantakat","year":"2015","journal-title":"Res Dev Disabil"},{"key":"2023011802392140900_ref18","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1186\/1471-2474-9-150","article-title":"Development of spasticity with age in a total population of children with cerebral palsy","volume":"9","author":"H\u00e4gglund","year":"2008","journal-title":"BMC Musculoskelet Disord"},{"key":"2023011802392140900_ref19","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.gaitpost.2017.02.026","article-title":"Energy cost during walking in association with age and body height in children and young adults with cerebral palsy","volume":"54","author":"Bolster","year":"2017","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref20","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1191\/0269215504cr735oa","article-title":"Locomotion skills in adults with cerebral palsy","volume":"18","author":"Jahnsen","year":"2004","journal-title":"Clin Rehabil"},{"key":"2023011802392140900_ref21","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/j.1469-8749.2008.03250.x","article-title":"Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up study","volume":"51","author":"Opheim","year":"2009","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref22","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/j.1651-2227.2009.01626.x","article-title":"Pain in children with cerebral palsy: a cross-sectional multicentre European study","volume":"99","author":"Parkinson","year":"2010","journal-title":"Acta Paediatr Int J Paediatr"},{"key":"2023011802392140900_ref23","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/dmcn.12660","article-title":"Exercise interventions improve postural control in children with cerebral palsy: a systematic review","volume":"57","author":"Dewar","year":"2015","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref24","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.gaitpost.2018.05.004","article-title":"Gait pathology subtypes are not associated with self-reported fall frequency in children with cerebral palsy","volume":"63","author":"Boyer","year":"2018","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref25","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3109\/17518423.2012.725107","article-title":"Performance of adults with cerebral palsy related to falls, balance and function: a preliminary report","volume":"16","author":"Morgan","year":"2013","journal-title":"Dev Neurorehabil"},{"key":"2023011802392140900_ref26","first-page":"1","article-title":"Perceived cause, environmental factors, and consequences of falls in adults with cerebral palsy: a preliminary mixed methods study","volume":"2015","author":"Morgan","year":"2015","journal-title":"Rehabil Res Pract"},{"key":"2023011802392140900_ref27","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1469-8749.2007.00450.x","article-title":"Physical and sedentary activity in adolescents with cerebral palsy","volume":"49","author":"Maher","year":"2007","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref28","doi-asserted-by":"crossref","first-page":"647","DOI":"10.3109\/09638288.2012.715721","article-title":"Differences in habitual physical activity levels of young people with cerebral palsy and their typically developing peers: a systematic review","volume":"35","author":"Carlon","year":"2013","journal-title":"Disabil Rehabil"},{"key":"2023011802392140900_ref29","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1001\/jama.2015.11025","article-title":"Chronic conditions in adults with cerebral palsy","volume":"314","author":"Peterson","year":"2015","journal-title":"JAMA"},{"key":"2023011802392140900_ref30","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1136\/bmj.b1458","article-title":"Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study","volume":"338","author":"Fauconnier","year":"2009","journal-title":"BMJ"},{"key":"2023011802392140900_ref31","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1093\/ptj\/78.5.458","article-title":"Association between characteristics of locomotion and accomplishment of life habits in children with cerebral palsy","volume":"78","author":"Lepage","year":"1998","journal-title":"Phys Ther"},{"key":"2023011802392140900_ref32","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.apmr.2007.04.002","article-title":"Prospective longitudinal study of gross motor function in children with cerebral palsy","volume":"88","author":"Voorman","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011802392140900_ref33","doi-asserted-by":"crossref","first-page":"3164","DOI":"10.1080\/09638288.2017.1380719","article-title":"Influence of trunk control and lower extremity impairments on gait capacity in children with cerebral palsy","volume":"40","author":"Balzer","year":"2018","journal-title":"Disabil Rehabil"},{"key":"2023011802392140900_ref34","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.apmr.2007.06.011","article-title":"Relationships between spasticity, strength, gait, and the GMFM-66 in persons with spastic diplegia cerebral palsy","volume":"88","author":"Ross","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011802392140900_ref35","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00001577-199608040-00011","article-title":"Relationship between clinical measures of balance and functional abilities in children with cerebral palsy","volume":"8","author":"Lowes","year":"1996","journal-title":"Pediatr Phys Ther"},{"key":"2023011802392140900_ref36","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/j.1469-8749.2010.03777.x","article-title":"Causal relation between spasticity, strength, gross motor function, and functional outcome in children with cerebral palsy: a path analysis","volume":"53","author":"Kim","year":"2011","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref37","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/dmcn.14024","article-title":"Selective motor control and gross motor function in bilateral spastic cerebral palsy","volume":"61","author":"Noble","year":"2019","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref38","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1016\/j.ridd.2013.02.003","article-title":"Structural equation modeling of motor impairment, gross motor function, and the functional outcome in children with cerebral palsy","volume":"34","author":"Park","year":"2013","journal-title":"Res Dev Disabil"},{"key":"2023011802392140900_ref39","doi-asserted-by":"crossref","first-page":"383","DOI":"10.3233\/NRE-172340","article-title":"Change in mobility function and its causes in adults with cerebral palsy by gross motor function classification system level: a cross-sectional questionnaire study","volume":"42","author":"Himuro","year":"2018","journal-title":"NeuroRehabilitation"},{"key":"2023011802392140900_ref40","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0033-2909.112.1.155","article-title":"A power primer","volume":"112","author":"Cohen","year":"1992","journal-title":"Psychol Bull"},{"key":"2023011802392140900_ref41","first-page":"614","article-title":"Biostatistics 104: correlation analysis","volume":"44","author":"Chan","year":"2003","journal-title":"Signapore Med J"},{"key":"2023011802392140900_ref42","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.gaitpost.2015.12.003","article-title":"Using a goal attainment scale in the evaluation of outcomes in patients with diplegic cerebral palsy","volume":"44","author":"McMorran","year":"2016","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref43","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.gaitpost.2010.09.028","article-title":"Modified goal attainment scale outcomes for ambulatory children: with and without orthopedic surgery","volume":"33","author":"Gordon","year":"2011","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref44","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/j.1365-2214.2010.01121.x","article-title":"Domains of importance for parents, medical professionals, and youth with cerebral palsy considering treatment outcomes","volume":"37","author":"Vargus-Adams","year":"2011","journal-title":"Child Care Health Dev"},{"key":"2023011802392140900_ref45","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1017\/S001216220600096X","article-title":"The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the generic core scales and cerebral palsy module","volume":"48","author":"Varni","year":"2006","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref46","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/ageing\/afl077","article-title":"Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?","volume":"35","author":"Horak","year":"2006","journal-title":"Age Ageing"},{"key":"2023011802392140900_ref47","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1469-8749.2003.tb00399.x","article-title":"Fatigue in adults with cerebral palsy in Norway compared with the general population","volume":"45","author":"Jahnsen","year":"2003","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref48","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/01202412-200411000-00002","article-title":"A 2-year follow-up of outcomes following orthopedic surgery or selective dorsal rhizotomy in children with spastic diplegia","volume":"13","author":"Thomas","year":"2004","journal-title":"J Pediatr Orthop Part B"},{"key":"2023011802392140900_ref49","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1469-8749.2008.02030.x","article-title":"Energy efficiency in gait, activity, participation, and health status in children with cerebral palsy","volume":"50","author":"Kerr","year":"2008","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref50","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1097\/00005768-199612000-00009","article-title":"Role of cocontraction in the O2 cost of walking in children with cerebral palsy","volume":"28","author":"Unnithan","year":"1996","journal-title":"Med Sci Sports Exerc"},{"key":"2023011802392140900_ref51","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.gaitpost.2019.07.009","article-title":"Spasticity reduction in children with cerebral palsy is not associated with reduced energy during walking","volume":"73","author":"Zaino","year":"2019","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref52","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/j.apmr.2018.01.020","article-title":"Functional capacity in adults with cerebral palsy: lower limb muscle strength matters","volume":"99","author":"Gillett","year":"2018","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011802392140900_ref53","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.clinbiomech.2019.06.013","article-title":"Muscle architecture in children with cerebral palsy and ankle contractures: an investigation using diffusion tensor imaging","volume":"68","author":"D\u2019Souza","year":"2019","journal-title":"Clin Biomech"},{"key":"2023011802392140900_ref54","doi-asserted-by":"crossref","first-page":"579","DOI":"10.3109\/09638288.2014.935492","article-title":"Does muscle size matter? The relationship between muscle size and strength in children with cerebral palsy","volume":"37","author":"Reid","year":"2015","journal-title":"Disabil Rehabil"},{"key":"2023011802392140900_ref55","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1111\/j.1469-8749.2010.03686.x","article-title":"Gross muscle morphology and structure in spastic cerebral palsy: a systematic review","volume":"52","author":"Barrett","year":"2010","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref56","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.braindev.2013.05.008","article-title":"Lower limb muscle volumes in bilateral spastic cerebral palsy","volume":"36","author":"Noble","year":"2014","journal-title":"Brain Dev"},{"key":"2023011802392140900_ref57","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1111\/j.1469-8749.2003.tb00954.x","article-title":"Contributing factors to muscle weakness in children with cerebral palsy","volume":"45","author":"Elder","year":"2003","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref58","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1002\/mus.20302","article-title":"Voluntary muscle activation, contractile properties, and fatigability in children with and without cerebral palsy","volume":"31","author":"Stackhouse","year":"2005","journal-title":"Muscle Nerve"},{"key":"2023011802392140900_ref59","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.2106\/JBJS.RVW.18.00153","article-title":"Sarcopenia, cerebral palsy, and botulinum toxin type a","volume":"7","author":"Multani","year":"2019","journal-title":"JBJS Rev"},{"key":"2023011802392140900_ref60","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1177\/1545968317723750","article-title":"Improved walking capacity and muscle strength after functional power-training in young children with cerebral palsy","volume":"31","author":"Van Vulpen","year":"2017","journal-title":"Neurorehabil Neural Repair"},{"key":"2023011802392140900_ref61","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.ridd.2013.10.021","article-title":"Meta-analysis of the effect of strengthening interventions in individuals with cerebral palsy","volume":"35","author":"Park","year":"2014","journal-title":"Res Dev Disabil"},{"key":"2023011802392140900_ref62","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2340\/16501977-0983","article-title":"The evidence-base for basic physical therapy techniques targeting lower limb function in children with cerebral palsy: a systematic review using the international classification of functioning, disability and health as a conceptual framework","volume":"44","author":"Franki","year":"2012","journal-title":"J Rehabil Med"},{"key":"2023011802392140900_ref63","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/1545968312469834","article-title":"Differential adaptations of muscle architecture to high-velocity versus traditional strength training in cerebral palsy","volume":"27","author":"Moreau","year":"2013","journal-title":"Neurorehabil Neural Repair"},{"key":"2023011802392140900_ref64","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1016\/j.apmr.2018.06.010","article-title":"Does home-based progressive resistance or high-intensity circuit training improve strength, function, activity or participation in children with cerebral palsy?","volume":"99","author":"Schranz","year":"2018","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011802392140900_ref65","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3109\/21679169.2013.795241","article-title":"Falls, fear of falling and falls risk in adults with cerebral palsy: a pilot observational study","volume":"15","author":"Morgan","year":"2013","journal-title":"Eur J Physiother"},{"key":"2023011802392140900_ref66","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.gaitpost.2018.05.004","article-title":"Gait pathology subtypes are not associated with self-reported fall frequency in children with cerebral palsy","volume":"63","author":"Boyer","year":"2018","journal-title":"Gait Posture"},{"key":"2023011802392140900_ref67","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1017\/S0012162206002106","article-title":"Do the abilities of children with cerebral palsy explain their activities and participation?","volume":"48","author":"Morris","year":"2006","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref68","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ejpn.2008.03.005","article-title":"Frequency of participation of 8-12-year-old children with cerebral palsy: a multi-centre cross-sectional European study","volume":"13","author":"Michelsen","year":"2009","journal-title":"Eur J Paediatr Neurol"},{"key":"2023011802392140900_ref69","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.apmr.2019.08.475","article-title":"Acute and chronic pain in children and adolescents with cerebral palsy: prevalence, interference, and management","volume":"101","author":"Ostojic","year":"2020","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011802392140900_ref70","first-page":"240","article-title":"Health status of school-aged children with cerebral palsy: information from a population-based sample","volume":"2","author":"Kennes","year":"2002","journal-title":"Children"},{"key":"2023011802392140900_ref71","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2013-0224","article-title":"Characteristics of pain in children and youth with cerebral palsy","volume":"132","author":"Penner","year":"2013","journal-title":"Pediatrics"},{"key":"2023011802392140900_ref72","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PR9.0000000000000666","article-title":"Psychometric properties of the brief pain inventory modified for proxy report of pain interference in children with cerebral palsy with and without cognitive impairment","volume":"3","author":"Barney","year":"2018","journal-title":"Pain Reports"},{"key":"2023011802392140900_ref73","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/j.apmr.2017.03.013","article-title":"Long-term deterioration of perceived health and functioning in adults with cerebral palsy","volume":"98","author":"Benner","year":"2017","journal-title":"Arch Phys Med Rehabil"},{"key":"2023011802392140900_ref74","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/BPO.0000000000000320","article-title":"Relationship of strength, weight, age, and function in ambulatory children with cerebral palsy","volume":"35","author":"Davids","year":"2015","journal-title":"J Pediatr Orthop"},{"key":"2023011802392140900_ref75","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1136\/archdischild-2012-303482","article-title":"Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study","volume":"98","author":"Parkinson","year":"2013","journal-title":"Arch Dis Child"},{"key":"2023011802392140900_ref76","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1111\/dmcn.14113","article-title":"Factors associated with pain in adolescents with bilateral cerebral palsy","volume":"61","author":"Fairhurst","year":"2019","journal-title":"Dev Med Child Neurol"},{"key":"2023011802392140900_ref77","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/DBP.0000000000000118","article-title":"A comparison of observers and self-report pain ratings for children with cerebral palsy","volume":"36","author":"Hadden","year":"2015","journal-title":"J Dev Behav Pediatr"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzab102\/36684650\/pzab102.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/101\/7\/pzab102\/48747266\/pzab102.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/101\/7\/pzab102\/48747266\/pzab102.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T17:50:43Z","timestamp":1724694643000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/doi\/10.1093\/ptj\/pzab102\/6184953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,24]]},"references-count":77,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ptj\/pzab102","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,3,24]]},"article-number":"pzab102"}}