{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:03:36Z","timestamp":1784304216124,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,4,9]],"date-time":"2023-04-09T00:00:00Z","timestamp":1680998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,4,9]],"date-time":"2023-04-09T00:00:00Z","timestamp":1680998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1171758"],"award-info":[{"award-number":["APP1171758"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify implementation strategies and safety outcomes (adverse events) of community\u2010based physical activity interventions for adolescents and adults with complex cerebral palsy (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Five electronic databases were systematically searched to April 2022. Data were extracted on the implementation and safety of physical activity interventions for adolescents and adults with CP, classified in Gross Motor Function Classification System (GMFCS) levels IV and V, delivered in a community setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen studies with 262 participants (160 participants classified in GMFCS levels IV or V) were included. Community settings included schools (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), participants' homes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), gymnasia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), swimming pools (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), and other settings (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094). Most studies specified medical or safety exclusion criteria. Implementation strategies included pre\u2010exercise screening, use of adapted equipment, familiarization sessions, supervision, physical assistance, and physiological monitoring. Attendance was high and attrition low. Nine studies reported non\u2010serious, expected, and related events. Four studies reported minor soreness and four studies reported minor fatigue post\u2010exercise. Serious adverse events related to exercise were infrequent (reported for 4 of 160 participants [&lt;2%]: three participants withdrew from an exercise programme and one participant ceased exercise for a short period). Most frequently reported was pain, requiring temporary exercise cessation or programme change, or study withdrawal (three participants).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>For most adolescents and adults with CP classified in GMFCS levels IV and V, physical activity interventions can be safely performed in a community setting, without post\u2010exercise pain or fatigue, or serious adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What this paper adds<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Supervised community\u2010based physical activity interventions can be safely performed by people with complex cerebral palsy.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Post\u2010exercise pain or fatigue was not common among those classified in Gross Motor Function Classification System levels IV or V.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Serious adverse events are infrequent when exercising in community settings, with safety strategies.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.15611","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T01:34:29Z","timestamp":1681090469000},"page":"1451-1463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Community\u2010based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2573-6562","authenticated-orcid":false,"given":"Prue","family":"Morgan","sequence":"first","affiliation":[{"name":"Department of Physiotherapy Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7378-5457","authenticated-orcid":false,"given":"Stacey","family":"Cleary","sequence":"additional","affiliation":[{"name":"Neurodisability and Rehabilitation Murdoch Children's Research Institute  Parkville Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0368-6410","authenticated-orcid":false,"given":"Iain","family":"Dutia","sequence":"additional","affiliation":[{"name":"Physiotherapy, 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