Abstract：
OBJECTIVE: This study aims to evaluate the effect of a performance-focused swimming programme on motor function in previously untrained adolescents with cerebral palsy and high support needs (CPHSN) and to determine whether the motor decline typical of adolescents with CPHSN occurred in these swimmers.
METHODS: A Multiple-Baseline, Single-Case Experimental Design (MB-SCED) study comprising five phases and a 30-month follow-up was conducted. Participants were two males and one female, all aged 15 years, untrained and with CPHSN. The intervention was a 46-month swimming training programme, focused exclusively on improving performance. Outcomes were swim performance (velocity); training load (rating of perceived exertion min/week; swim distance/week) and Gross Motor Function Measure-66-Item Set (GMFM-66). MB-SCED data were analysed using interrupted time-series simulation analysis. Motor function over 46 months was modelled (generalised additive model) using GMFM-66 scores and compared with a model of predicted motor decline.
RESULTS: Improvements in GMFM-66 scores in response to training were significant (p<0.001), and two periods of training withdrawal each resulted in significant motor decline (p≤0.001). Participant motor function remained above baseline levels for the study duration, and, importantly, participants did not experience the motor decline typical of other adolescents with CPHSN. Weekly training volumes were also commensurate with WHO recommended physical activity levels.
CONCLUSIONS: Results suggest that adolescents with CPHSN who meet physical activity guidelines through participation in competitive swimming may prevent motor decline. However, this population is clinically complex, and in order to permit safe, effective participation in competitive sport, priority should be placed on the development of programmes delivered by skilled multiprofessional teams.
BACKGROUND: ACTRN12616000326493.
METHODS: A Multiple-Baseline, Single-Case Experimental Design (MB-SCED) study comprising five phases and a 30-month follow-up was conducted. Participants were two males and one female, all aged 15 years, untrained and with CPHSN. The intervention was a 46-month swimming training programme, focused exclusively on improving performance. Outcomes were swim performance (velocity); training load (rating of perceived exertion min/week; swim distance/week) and Gross Motor Function Measure-66-Item Set (GMFM-66). MB-SCED data were analysed using interrupted time-series simulation analysis. Motor function over 46 months was modelled (generalised additive model) using GMFM-66 scores and compared with a model of predicted motor decline.
RESULTS: Improvements in GMFM-66 scores in response to training were significant (p<0.001), and two periods of training withdrawal each resulted in significant motor decline (p≤0.001). Participant motor function remained above baseline levels for the study duration, and, importantly, participants did not experience the motor decline typical of other adolescents with CPHSN. Weekly training volumes were also commensurate with WHO recommended physical activity levels.
CONCLUSIONS: Results suggest that adolescents with CPHSN who meet physical activity guidelines through participation in competitive swimming may prevent motor decline. However, this population is clinically complex, and in order to permit safe, effective participation in competitive sport, priority should be placed on the development of programmes delivered by skilled multiprofessional teams.
BACKGROUND: ACTRN12616000326493.
摘要：
目的：本研究旨在评估以表现为重点的游泳计划对先前未经训练的脑瘫和高支持需求青少年（CPHSN）运动功能的影响，并确定CPHSN青少年的典型运动衰退是否发生在这些游泳者身上。
方法：多基线，单病例实验设计（MB-SCED）研究包括五个阶段和30个月的随访。参与者是两名男性和一名女性，所有15岁的人，未经训练和CPHSN。干预是一项为期46个月的游泳训练计划，专注于提高性能。结果是游泳表现（速度）；训练负荷（感知最小/周的运动等级；游泳距离/周）和粗大运动功能测量66项目集（GMFM-66）。使用中断时间序列模拟分析对MB-SCED数据进行分析。使用GMFM-66评分对46个月的运动功能进行建模（广义加法模型），并与预测的运动衰退模型进行比较。
结果：对训练的反应GMFM-66得分的改善是显著的（p<0.001），和两个训练期各自导致显著的运动下降(p≤0.001)。参与者运动功能在研究期间保持在基线水平以上，and,重要的是,参与者没有出现其他CPHSN青少年典型的运动衰退.每周训练量也与世卫组织建议的身体活动水平相称。
结论：研究结果表明，CPHSN青少年通过参加竞技游泳符合体力活动指南，可以防止运动衰退。然而,这个人群在临床上很复杂，为了安全，有效参与竞技体育，应优先考虑制定由熟练的多专业团队提供的方案。
背景：ACTRN12616000326493。
方法：多基线，单病例实验设计（MB-SCED）研究包括五个阶段和30个月的随访。参与者是两名男性和一名女性，所有15岁的人，未经训练和CPHSN。干预是一项为期46个月的游泳训练计划，专注于提高性能。结果是游泳表现（速度）；训练负荷（感知最小/周的运动等级；游泳距离/周）和粗大运动功能测量66项目集（GMFM-66）。使用中断时间序列模拟分析对MB-SCED数据进行分析。使用GMFM-66评分对46个月的运动功能进行建模（广义加法模型），并与预测的运动衰退模型进行比较。
结果：对训练的反应GMFM-66得分的改善是显著的（p<0.001），和两个训练期各自导致显著的运动下降(p≤0.001)。参与者运动功能在研究期间保持在基线水平以上，and,重要的是,参与者没有出现其他CPHSN青少年典型的运动衰退.每周训练量也与世卫组织建议的身体活动水平相称。
结论：研究结果表明，CPHSN青少年通过参加竞技游泳符合体力活动指南，可以防止运动衰退。然而,这个人群在临床上很复杂，为了安全，有效参与竞技体育，应优先考虑制定由熟练的多专业团队提供的方案。
背景：ACTRN12616000326493。
