{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:39:25Z","timestamp":1792679965600,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004875","name":"Norrbacka-Eugeniastiftelsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004875","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007865","name":"Stichting Rotterdams Kinderrevalidatie Fonds Adriaanstichting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008588","name":"Stiftelsen Sunnerdahls Handikappfond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008588","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008340","name":"Elsass Fonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008340","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009389","name":"Stiftelsen Promobilia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009389","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011916","name":"JKF Kinderfonds","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011916","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":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the integrated cardiopulmonary, metabolic, and muscular response to incremental exercise in individuals with cerebral palsy (CP) compared with typically developing participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a prospective cross\u2010sectional study. Sixteen (seven male) individuals with CP (classified in Gross Motor Function Classification System levels II\u2013V) and 30 (15 male) typically developing participants performed a treadmill\u2010based incremental submaximal test and an exercise test to task failure. Participants used running frames (CP) or performed traditional running (typically developing participants). Metabolic and cardiopulmonary parameters were measured during both tests. Electromyography of the vastus lateralis and gastrocnemius medialis was recorded during the test to task failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with typically developing participants, individuals with CP showed decreased minute ventilation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), increased respiratory frequency at a comparable exercise intensity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and an altered metabolic response, on the basis of the partial pressure of carbon dioxide (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and lactate levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), during both tests. In addition, participants with CP exhibited a lower ventilatory efficiency during the test to task failure (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Electromyography analysis suggested peripheral skeletal muscle fatigue in the lower limbs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) in individuals with CP compared with typically developing participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Individuals with CP have a disproportional ventilatory response to incremental exercise, not driven by metabolic perturbations. The increased breathing frequency resulted in high rate of perceived exertion and signs of peripheral muscle fatigue compared with typically developing participants. Our findings stress the importance of interventions focused on ventilatory function in individuals with CP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.70164","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T04:45:40Z","timestamp":1768797940000},"page":"1139-1151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Disproportional ventilatory response to incremental exercise in individuals with cerebral palsy"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7489-3280","authenticated-orcid":false,"given":"Linn\u00e9a","family":"Corell","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health, Division of Pediatric Neurology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0089-5209","authenticated-orcid":false,"given":"Emma","family":"Hjalmarsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Division of Pediatric Neurology Karolinska Institutet  Stockholm Sweden"},{"name":"Medical Unit Allied Health Professionals, Women's and Children's Health, Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2816-9855","authenticated-orcid":false,"given":"Rodrigo","family":"Fernandez\u2010Gonzalo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Division of Clinical Physiology Karolinska Institutet  Stockholm Sweden"},{"name":"Unit of Clinical Physiology, Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6754-1253","authenticated-orcid":false,"given":"Annika","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Division of Pediatric Neurology Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Human Movement Science, Sport and Health University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2921-833X","authenticated-orcid":false,"given":"Sebastian","family":"Edman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Division of Pediatric Neurology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9652-4594","authenticated-orcid":false,"given":"Asta","family":"Kizyte","sequence":"additional","affiliation":[{"name":"KTH MoveAbility, Department of Engineering Mechanics Royal Institute of Technology, KTH  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2232-5258","authenticated-orcid":false,"given":"Rouli","family":"Wang","sequence":"additional","affiliation":[{"name":"KTH MoveAbility, Department of Engineering Mechanics Royal Institute of Technology, KTH  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8092-5155","authenticated-orcid":false,"given":"Arnoud Edelman","family":"Bos","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Vrije Universiteit Amsterdam, Rehabilitation Medicine  Amsterdam Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation &amp; Development  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5828-0015","authenticated-orcid":false,"given":"Peder","family":"S\u00f6rensson","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Cardiology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-1914","authenticated-orcid":false,"given":"Eva","family":"Pont\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Division of Pediatric Neurology Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pediatric Orthopedic Surgery Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2694-1824","authenticated-orcid":false,"given":"Petra E. M.","family":"van Schie","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Vrije Universiteit Amsterdam, Rehabilitation Medicine  Amsterdam Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation &amp; Development  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5662-2843","authenticated-orcid":false,"given":"Annemieke I.","family":"Buizer","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Vrije Universiteit Amsterdam, Rehabilitation Medicine  Amsterdam Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation &amp; Development  Amsterdam Netherlands"},{"name":"Emma Children's Hospital, Amsterdam UMC  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6004-1117","authenticated-orcid":false,"given":"Jessica","family":"Norrbom","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8607-550X","authenticated-orcid":false,"given":"Daniele A.","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"},{"name":"The Swedish Sports Confederation (Riksidrottsf\u00f6rbundet)  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1134-2252","authenticated-orcid":false,"given":"Ferdinand","family":"von Walden","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Division of Pediatric Neurology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15346"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.16274"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.00450.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2010.07.005"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3182732b2f"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008199"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP275013"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP274596"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2020.107808"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmet.2023.101854"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2023.108638"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1042\/BST20110720"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100120603"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14785"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14964"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2006.11.006"},{"issue":"2","key":"e_1_2_10_18_1","first-page":"113","article-title":"Differences of respiratory function in children with spastic diplegic and hemiplegic cerebral palsy, compared with normally developed children","volume":"6","author":"Kwon YH","year":"2013","journal-title":"J Pediatr Rehabil Med."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2019.05.010"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEP.0000000000000947"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2005.tb01135.x"},{"key":"e_1_2_10_22_1","article-title":"Circulating immune cell populations at rest and in response to acute endurance exercise in young adults with cerebral palsy","author":"Kruse A","year":"2023","journal-title":"Dev Med Child Neurol."},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2015.1102315"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00827.2017"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.38.6.1104"},{"key":"e_1_2_10_26_1","unstructured":"InitiativeGLF.The Global Lung Function Initiative calculators for Spirometry TLCO and Lung volume 2021[Available from:https:\/\/gli\u2010calculator.ersnet.org\/index.html."},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2165\/11319670-000000000-00000"},{"issue":"6","key":"e_1_2_10_28_1","first-page":"404","article-title":"Physical activity and the prevention of coronary heart disease","volume":"3","author":"Fox SM","year":"1971","journal-title":"Ann Clin Res."},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1050-6411(00)00027-4"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2011.05.002"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1970.tb06140.x"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00035205"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0101-2018"},{"key":"e_1_2_10_34_1","unstructured":"FerreiraM WagenfuhrJ Guar\u00e9R TufikS PoyaresD OliveiraW et\u00a0al.Is cerebral palsy associated with cardiac changes?2014. p.161\u20137."},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00659"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2016.1158801"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/589164"},{"key":"e_1_2_10_38_1","volume-title":"Wasserman & Whipp's Principles of Exercise Testing and Interpretation","author":"Sietsema KE","year":"2020"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2202033"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1993.sp019477"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1997.82.5.1573"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1123\/apaq.2024-0153"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-1821"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00028103"}],"container-title":["Developmental Medicine &amp; Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.70164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dmcn.70164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.70164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T03:15:35Z","timestamp":1789355735000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dmcn.70164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,18]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/dmcn.70164"],"URL":"https:\/\/doi.org\/10.1111\/dmcn.70164","archive":["Portico"],"relation":{},"ISSN":["0012-1622","1469-8749"],"issn-type":[{"value":"0012-1622","type":"print"},{"value":"1469-8749","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,18]]},"assertion":[{"value":"2025-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}