{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:59:27Z","timestamp":1790063967819,"version":"4.0.1"},"reference-count":39,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: Adults with cerebral palsy (Gross Motor Function Classification System, GMFCS, levels III\u2013V) have severely impaired motor function, causing fatigue, pain, constipation, and sleep disturbance, reducing life quality. Whether standard exercise is feasible or beneficial in this population is unknown, as spasticity, low muscle mass, and cognitive challenges may limit participation. Unable to engage in conventional exercise, they require tailored modalities. This study investigated whether assisted cycling is feasible and could improve key symptoms.\nMethods: 14 adults with cerebral palsy (GMFCS III-V) completed a 10-week control period and 10 weeks of supervised, assisted cycling (3 x 20 min\/week). Assessments at baseline, post-control, and post-exercise included key symptoms, feasibility, Gross Motor Function Measure-88, and a timed 1-km cycle test (time, power output, cadence).\nResults: Median attendance was 24\/30 sessions. Heart rate increased during exercise (median 25.5 bpm). No significant group-level changes were observed, but individual improvements in pain, constipation, and power output were observed in some. Two participants experienced moderate adverse events affecting daily living.\nConclusion: Assisted cycling is feasible and generally well tolerated in non-ambulant adults with cerebral palsy. While no group-level effects were detected, exploratory individual improvements in symptoms and cycling performance were observed in some, supporting further research on tailored exercise.<\/jats:p>","DOI":"10.2340\/jrm.v58.45792","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:59:31Z","timestamp":1790060371000},"page":"jrm45792","source":"Crossref","is-referenced-by-count":0,"title":["Assisted cycling in non-ambulant adults with cerebral palsy: exploratory effects and feasibility in residential care"],"prefix":"10.2340","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3739-8759","authenticated-orcid":false,"given":"Nanna S.","family":"Poulsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Falkenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2959-361X","authenticated-orcid":false,"given":"No\u00e9mie","family":"Receveur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2011-642X","authenticated-orcid":false,"given":"Sophia V.","family":"Fr\u00f8lich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9962-6892","authenticated-orcid":false,"given":"Helle","family":"H\u00fcche Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6144-8544","authenticated-orcid":false,"given":"John","family":"Vissing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"168838","unstructured":"Vitrikas K, Dalton H, Breish D. Cerebral palsy: an overview. Am Fam Physician 2020; 101: 213\u2013220."},{"key":"168839","doi-asserted-by":"crossref","unstructured":"Puce L, Pallecchi I, Chamari K, Marinelli L, Innocenti T, Pedrini R, et al. Systematic review of fatigue in individuals with cerebral palsy. Front Hum Neurosci 2021; 15: 598800.","DOI":"10.3389\/fnhum.2021.598800"},{"key":"168840","doi-asserted-by":"crossref","unstructured":"Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics 2012; 130: e1285\u2013e1312.","DOI":"10.1542\/peds.2012-0924"},{"key":"168841","doi-asserted-by":"crossref","unstructured":"Del Giudice E, Staiano A, Capano G, Romano A, Florimonte L, Miele E, et al. Gastrointestinal manifestations in children with cerebral palsy. Brain Dev 1999; 21: 307\u2013311.","DOI":"10.1016\/S0387-7604(99)00025-X"},{"key":"168842","doi-asserted-by":"crossref","unstructured":"Newman CJ, O\u2019Regan M, Hensey O. Sleep disorders in children with cerebral palsy. Dev Med Child Neurol 2006; 48: 564\u2013568.","DOI":"10.1111\/j.1469-8749.2006.tb01316.x"},{"key":"168843","doi-asserted-by":"crossref","unstructured":"Clark J, Sarmiento C, Sanders J, Wang L, Fetsko L, Akamagwuna U. Navigating the complex care landscape: addressing challenges and advancing adult care frameworks for individuals with cerebral palsy. Health Care Transit 2024; 2: 100051.","DOI":"10.1016\/j.hctj.2024.100051"},{"key":"168844","doi-asserted-by":"crossref","unstructured":"Bell BG, Shah S, Coulson N, McLaughlin J, Logan P, Luke R, et al. The impact of ageing on adults with cerebral palsy: the results of a national online survey. BJGP Open 7(4): BJGPO.2023.0028.","DOI":"10.3399\/BJGPO.2023.0028"},{"key":"168845","doi-asserted-by":"crossref","unstructured":"Hulst RY, Gorter JW, Voorman JM, Kolk E, Vossen SVD, Visser-Meily JMA, et al. Sleep problems in children with cerebral palsy and their parents. Dev Med Child Neurol 2021; 63: 1344.","DOI":"10.1111\/dmcn.14920"},{"key":"168846","doi-asserted-by":"crossref","unstructured":"Veugelers R, Benninga MA, Calis EA, Willemsen SP, Evenhuis H, Tibboel D, et al. Prevalence and clinical presentation of constipation in children with severe generalized cerebral palsy. Dev Med Child Neurol 2010; 52: e216\u2013e221.","DOI":"10.1111\/j.1469-8749.2010.03701.x"},{"key":"168847","doi-asserted-by":"crossref","unstructured":"Jacobson DNO, L\u00f6wing K, Tedroff K. Health-related quality of life, pain, and fatigue in young adults with cerebral palsy. Dev Med Child Neurol 2020; 62: 372\u2013378.","DOI":"10.1111\/dmcn.14413"},{"key":"168848","doi-asserted-by":"crossref","unstructured":"Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; 2017: CD011279.","DOI":"10.1002\/14651858.CD011279.pub2"},{"key":"168849","doi-asserted-by":"crossref","unstructured":"De Schryver AM, Keulemans YC, Peters HP, Akkermans LM, Smout AJ, De Vries WR, et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scand J Gastroenterol 2005; 40: 422\u2013429.","DOI":"10.1080\/00365520510011641"},{"key":"168850","doi-asserted-by":"crossref","unstructured":"Marquez DX, Agui\u00f1aga S, V\u00e1squez PM, Conroy DE, Erickson KI, Hillman C, et al. A systematic review of physical activity and quality of life and well-being. Transl Behav Med 2020; 10: 1098\u20131109.","DOI":"10.1093\/tbm\/ibz198"},{"key":"168851","doi-asserted-by":"crossref","unstructured":"Lungu C, Hirtz D, Damiano D, Gross P, Mink JW. Report of a workshop on research gaps in the treatment of cerebral palsy. Neurology 2016; 87: 1293\u20131298.","DOI":"10.1212\/WNL.0000000000003116"},{"key":"168852","doi-asserted-by":"crossref","unstructured":"H\u00fcche Larsen H, Frisk RF, Willerslev-Olsen M, Nielsen JB. Motor-learning based activities may improve functional ability in adults with severe cerebral palsy: a controlled pilot study. NeuroRehabilitation 2021; 48: 273\u2013283.","DOI":"10.3233\/NRE-201581"},{"key":"168853","doi-asserted-by":"crossref","unstructured":"Hutzler Y, Rodr\u00edguez BL, Laiz NM, D\u00edez I, Barak S. The effects of an exercise training program on hand and wrist strength, and function, and activities of daily living, in adults with severe cerebral palsy. Res Dev Disabil 2013; 34: 4343\u20134354.","DOI":"10.1016\/j.ridd.2013.09.015"},{"key":"168854","doi-asserted-by":"crossref","unstructured":"Terada K, Satonaka A, Terada Y, Suzuki N. Training effects of wheelchair dance on aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy rated to GMFCS level V. Eur J Phys Rehabil Med 2017; 53: 744\u2013750.","DOI":"10.23736\/S1973-9087.17.04486-0"},{"key":"168855","doi-asserted-by":"crossref","unstructured":"Taylor NF, Dodd KJ, Larkin H. Adults with cerebral palsy benefit from participating in a strength training programme at a community gymnasium. Disabil Rehabil 2004; 26: 1128\u20131134.","DOI":"10.1080\/09638280410001712387"},{"key":"168856","doi-asserted-by":"crossref","unstructured":"Vogtle LK, Malone LA, Azuero A. Outcomes of an exercise program for pain and fatigue management in adults with cerebral palsy. Disabil Rehabil 2014; 36: 818\u2013825.","DOI":"10.3109\/09638288.2013.821181"},{"key":"168857","unstructured":"Ahmed Awan W, Masood T, Kanwal R. Effectiveness of physical therapy for improving constipation in spastic cerebral palsy. 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Psychiatry Res 1989; 28: 193\u2013213.","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"168861","doi-asserted-by":"crossref","unstructured":"Thomsen AS, Bech P. Possible error in the Danish version of the WHO Quality of Life (WHOQOL-BREF) Questionnaire. Nord J Psychiatry 2017; 71: 549\u2013550.","DOI":"10.1080\/08039488.2017.1352025"},{"key":"168862","doi-asserted-by":"crossref","unstructured":"Sprangers MA, Aaronson NK. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review. J Clin Epidemiol 1992; 45: 743\u2013760.","DOI":"10.1016\/0895-4356(92)90052-O"},{"key":"168863","doi-asserted-by":"crossref","unstructured":"Kooijmans R, van Langen M, Voss H, Reichrath E, Maljaars J, Dalemans R, et al. Does adapting a self-report instrument to improve its cognitive accessibility for people with intellectual disability result in a better measure? A cognitive interview study. 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Qual Life Res 2004; 13: 531\u2013540.","DOI":"10.1023\/B:QURE.0000018485.05372.d6"},{"key":"168867","doi-asserted-by":"crossref","unstructured":"Demuth SK, Knutson LM, Fowler EG. The PEDALS stationary cycling intervention and health-related quality of life in children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 2012; 54: 654\u2013661.","DOI":"10.1111\/j.1469-8749.2012.04321.x"},{"key":"168868","doi-asserted-by":"crossref","unstructured":"Soares EG, Gusm\u00e3o CHV, Souto DO. Efficacy of aerobic exercise on the functioning and quality of life of children and adolescents with cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2023; 65: 1292\u20131307.","DOI":"10.1111\/dmcn.15570"},{"key":"168869","doi-asserted-by":"crossref","unstructured":"Jansen J, Marshall PW, Benatar JR, Cross R, Lindbom TK, Kingsley M. Low-intensity resistance exercise in cardiac rehabilitation: a narrative review of mechanistic evidence and clinical implications. J Clin Med 2024; 13: 7338.","DOI":"10.3390\/jcm13237338"},{"key":"168870","doi-asserted-by":"crossref","unstructured":"Rubsam M, Girolami GL, Bhatt T. Dual task training interventions and mobility-based outcomes in children with cerebral palsy: a scoping review. Phys Occup Ther Pediatr 2025; 45: 652\u2013671.","DOI":"10.1080\/01942638.2025.2477792"},{"key":"168871","doi-asserted-by":"crossref","unstructured":"Lieber RL, Frid\u00e9n J. Muscle contracture and passive mechanics in cerebral palsy. J Appl Physiol 2019; 126: 1492\u20131501.","DOI":"10.1152\/japplphysiol.00278.2018"},{"key":"168872","doi-asserted-by":"crossref","unstructured":"Rice J, Skuza P, Baker F, Russo R, Fehlings D. Identification and measurement of dystonia in cerebral palsy. Dev Med Child Neurol 2017; 59: 1249\u20131255.","DOI":"10.1111\/dmcn.13502"},{"key":"168873","doi-asserted-by":"crossref","unstructured":"Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW, Task Force on Childhood Motor Disorders. Classification and definition of disorders causing hypertonia in childhood. Pediatrics 2003; 111: e89\u2013e97.","DOI":"10.1542\/peds.111.1.e89"},{"key":"168874","doi-asserted-by":"crossref","unstructured":"Merino-Andr\u00e9s J, Garc\u00eda de Mateos-L\u00f3pez A, Damiano DL, S\u00e1nchez-Sierra A. Effect of muscle strength training in children and adolescents with spastic cerebral palsy: a systematic review and meta-analysis. Clin Rehabil 2022; 36: 4\u201314.","DOI":"10.1177\/02692155211040199"},{"key":"168875","doi-asserted-by":"crossref","unstructured":"Harvey A, Smith N, Smith M, Ostojic K, Berryman C. Chronic pain in children and young people with cerebral palsy: a narrative review of challenges, advances, and future directions. BMC Med 2024; 22: 238.","DOI":"10.1186\/s12916-024-03458-0"},{"key":"168876","doi-asserted-by":"crossref","unstructured":"Chibnall JT, Tait RC. Pain assessment in cognitively impaired and unimpaired older adults: a comparison of four scales. Pain 2001; 92: 173\u2013186.","DOI":"10.1016\/S0304-3959(00)00485-1"}],"container-title":["Journal of Rehabilitation Medicine"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/45792\/55544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/45792\/55544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:59:54Z","timestamp":1790060394000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/view\/45792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":39,"URL":"https:\/\/doi.org\/10.2340\/jrm.v58.45792","relation":{},"ISSN":["1651-2081"],"issn-type":[{"value":"1651-2081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]}}}