Effect of designed aerobic exercise program on cardiopulmonary fitness in children with hemiparetic cerebral palsy. A randomized controlled trial

Background: Children with hemiparetic cerebral palsy (CP) often experience reduced cardiopulmonary fitness, limiting functional mobility and participation. Aerobic exercise has been shown to enhance fitness in pediatric CP. Objective: To investigate the effect of a designed aerobic exercise program on walking energy expenditure, aerobic capacity, and functional walking endurance in children with hemiparetic CP. Methods: Forty children with hemiparetic CP participated in this randomized controlled study, their age from 7–12 years and GMFCS I–II. They were randomly assigned to a study group (n = 20) and a control group (n = 20). The control group received the conventional physiotherapy program based on the neuro-developmental technique 45 minutes (3 sessions/week), while the study group received the same conventional physiotherapy program provided to control group besides a supervised designed 12-weeks aerobic exercise program for 45 minutes (3 sessions/week). Outcome measures included Energy Expenditure Index (EEI), maximal oxygen uptake (VO₂ max), and the Six-Minute Walk Test (6MWT), assessed pre- and post-intervention. Data was analyzed using mixed-design MANOVA. Results: There was a significant reduction in EEI (p < 0.001), a significant increase in VO₂ max (p < 0.001), and a significant improvement in 6MWT distance (p < 0.001) in the study group, whereas changes in the control group were not significant. Conclusion: The study findings support the integration of designed aerobic exercise training into pediatric rehabilitation programs to enhance cardiopulmonary fitness and functional outcomes in hemiparetic CP children.