{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:17:54Z","timestamp":1785161874009,"version":"3.55.0"},"reference-count":67,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Purpose: (1) To determine the contribution of diet, time spent outdoors, and habitual physical activity (PA) on vitamin D status in men with cerebral palsy (CP) compared to physical activity matched controls (TDC) without neurological impairment; (2) to determine the role of vitamin D on musculoskeletal health, morphology, and function in men with CP compared to TDC. Materials and methods: A cross-sectional comparison study where 24 active, ambulant men with CP aged 21.0 \u00b1 1.4 years (Gross Motor Function Classification Score (I\u2013II) and 24 healthy TDC aged 25.3 \u00b1 3.1 years completed in vivo assessment of musculoskeletal health, including: vastus lateralis anatomical cross-sectional area (VL ACSA), isometric knee extension maximal voluntary contraction (KE iMVC), 10 m sprint, vertical jumps (VJ), and radius and tibia bone ultrasound (US) Tus and Zus scores. Assessments of vitamin D status through venous samples of serum 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone, dietary vitamin D intake from food diary, and total sun exposure via questionnaire were also taken. Results: Men with CP had 40.5% weaker KE iMVC, 23.7% smaller VL ACSA, 22.2% lower VJ, 14.6% lower KE iMVC\/VL ACSA ratio, 22.4% lower KE iMVC\/body mass (BM) ratio, and 25.1% lower KE iMVC\/lean body mass (LBM) ratio (all p &lt; 0.05). Radius Tus and Zus scores were 1.75 and 1.57 standard deviations lower than TDC, respectively (p &lt; 0.05), whereas neither tibia Tus nor Zus scores showed any difference compared to TDC (p &gt; 0.05). The 25(OH)D was not different between groups, and 90.9% of men with CP and 91.7% of TDC had low 25(OH)D levels when compared to current UK recommendations. The 25(OH)D was positively associated with KE iMVC\/LBM ratio in men with CP (r = 0.500, p = 0.020) but not in TDC (r = 0.281, p = 0.104). Conclusion: Musculoskeletal outcomes in men with CP were lower than TDC, and despite there being no difference in levels of 25(OH)D between the groups, 25 (OH)D was associated with strength (KE iMVC\/LBM) in the CP group but not TDC. The findings suggest that vitamin D deficiency can accentuate some of the condition-specific impairments to musculoskeletal outcomes.<\/jats:p>","DOI":"10.3390\/nu13072481","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T11:26:10Z","timestamp":1626780370000},"page":"2481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Musculoskeletal Health in Active Ambulatory Men with Cerebral Palsy and the Impact of Vitamin D"],"prefix":"10.3390","volume":"13","author":[{"given":"Christina Kate","family":"Langley","sequence":"first","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"},{"name":"The Football Association, St Georges Park, Burton-Upon-Trent DE13 9RN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1466-3265","authenticated-orcid":false,"given":"Gladys Leopoldine","family":"Onamb\u00e9l\u00e9-Pearson","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Thomas","family":"Sims","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"},{"name":"The Football Association, St Georges Park, Burton-Upon-Trent DE13 9RN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayser","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan John","family":"Buffey","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"},{"name":"Department of Physical Education and Sport Sciences, University of Limerick, V94 T9PX Limerick, Ireland"},{"name":"Physical Activity for Health Cluster, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly Leigh","family":"Bardwell","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5261-2637","authenticated-orcid":false,"given":"Christopher Ian","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Sciences, Musculoskeletal Sciences and Sport Medicine Research Centre, Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra070553","article-title":"Vitamin D Deficiency","volume":"357","author":"Holick","year":"2007","journal-title":"N. 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