the-6-minute-frame-running-test-field-based-cardiopulmonary-exercise

The 6-Minute Frame Running Test - A Field-based Cardiopulmonary Exercise Test for Individuals with Cerebral Palsy

Cerebral palsy (CP) is a diverse childhood-onset motor disability that varies significantly in severity and impact. Individuals with more severe forms of ...

Karolinska Institutet

Karolinska University Hospital

Individuals with cerebral palsy (CP) are less physically active, spend more time sedentary and have lower cardiorespiratory endurance as compared to typically developed individuals. RaceRunning enables high-intensity exercise in individuals with CP with limited or no walking ability, using a three-wheeled running bike with a saddle and a chest plate for support, but no pedals. Training adaptations using this type of exercise are unknown.

RaceRunning training improves stamina and promotes skeletal muscle hypertrophy in young individuals with cerebral palsy.

Muscle contracture development is a major complication for individuals with cerebral palsy (CP) and has lifelong implications. In order to recognize contracture development early and to follow up on preventive interventions aimed at muscle health development, non-invasive, and easy to use methods are needed. The aim of the present study was to assess whether multi-frequency Bioimpedance (mfBIA) can be used to detect differences between skeletal muscle of individuals with CP and healthy controls. The mfBIA technique was applied to the medial gastrocnemius muscle of n = 24 adults with CP and n = 20 healthy controls of both genders. The phase angle (PA) and the centre frequency (fc) were significantly lower in individuals with CP when compared to controls; PA: - 25% for women and - 31.8% for men (P < 0.0001); fc: - 5.6% for women and - 5.2% for men (P < 0.009). The reactance (Xc) and the extracellular resistance (Re) of skeletal muscle from individuals with CP were significantly higher when compared to controls; Xc: + 9.9% for women and + 28.9% for men (P < 0.0001); Re: + 39.7% for women and + 91.2% for men (P < 0.0001). The present study shows that several mfBIA parameters differ significantly between individuals with CP and healthy controls. Furthermore, these changes correlated significantly with the severity of CP, as assessed using the GMFCS scale. The present data indicate that mfBIA shows promise in terms of being a useful diagnostic tool, capable of characterizing muscle health and its development in individuals with cerebral palsy.

Multi-frequency bioimpedance: a non-invasive tool for muscle-health assessment of adults with cerebral palsy.

The development of efficient resistance exercise protocols to counteract muscle dysfunction in cerebral palsy is warranted. Whether individuals with cerebral palsy are able to perform iso-inertial resistance (flywheel) exercise in a comparable manner to typically developed subjects has never been experimentally tested.

Comparative analysis of power, work and muscle activation during weight-stack and iso-inertial flywheel resistance exercise in young adults with cerebral palsy.

Frame Running (RaceRunning) allows people with moderate-to-severe mobility impairments to participate in physical activity using a 3-wheeled frame with a saddle and handlebars. The aim of this study was to investigate athlete-perceived impact of Frame Running on aspects of physical fitness, functional mobility and psychosocial outcomes.

Athlete-Perceived Impact of Frame Running on Physical Fitness, Functional Mobility and Psychosocial Outcomes.

To determine the physiological response and association to peak oxygen uptake of the 6-minute Frame Running test (6-MFRT) in persons with cerebral palsy (CP).

Physiological Response to the 6-Minute Frame Running Test in Children and Adults With Cerebral Palsy.

In this study, the properties of circulating extracellular vesicles (EVs) were examined in cerebral palsy (CP) and typically developed (TD) individuals at rest and after aerobic exercise, focusing on the size, concentration, and microRNA cargo of EVs. Nine adult individuals with CP performed a single exercise bout consisting of 45 min of Frame Running, and TD participants completed either 45 min of cycling ( = 10; TD EX) or were enrolled as controls with no exercise ( = 10; TD CON). Blood was drawn before and 30 min after exercise and analyzed for EV concentration, size, and microRNA content. The size of EVs was similar in CP vs. TD, and exercise had no effect. Individuals with CP had an overall lower concentration (∼25%,  < 0.05) of EVs. At baseline, let-7a, let-7b and let-7e were downregulated in individuals with CP compared to TD ( < 0.05), while miR-100 expression was higher, and miR-877 and miR-4433 lower in CP compared to TD after exercise ( < 0.05). Interestingly, miR-486 was upregulated ∼2-fold in the EVs of CP vs. TD both at baseline and after exercise. We then performed an  analysis of miR-486 targets and identified the satellite cell stemness factor Pax7 as a target of miR-486. C2C12 myoblasts were cultured with a miR-486  and RNA-sequencing was performed. Gene enrichment analysis revealed that several genes involved in sarcomerogenesis and extracellular matrix (ECM) were downregulated. Our data suggest that circulating miR-486 transported by EVs is elevated in individuals with CP and that miR-486 alters the transcriptome of myoblasts affecting both ECM- and sarcomerogenesis-related genes, providing a link to the skeletal muscle alterations observed in individuals with CP.

Extracellular vesicle characteristics and microRNA content in cerebral palsy and typically developed individuals at rest and in response to aerobic exercise.

The aim of the study were to (1) investigate what physical and physiological parameters are most important for Frame Running capacity, a parasport for individuals with ambulatory difficulties, and (2) determine whether Frame Running capacity can be predicted in athletes with cerebral palsy.

Determinants of Frame Running Capacity in Athletes With Cerebral Palsy to Improve Training Routines and Classification Strategies: A Cross-sectional Observational Study.

The aim of this observational study was to determine the immune status and function in young adults with cerebral palsy (CP) in comparison to typically developing individuals.

Circulating immune cell populations at rest and in response to acute endurance exercise in young adults with cerebral palsy.

Individuals with cerebral palsy (CP) are at risk of poor health due to low aerobic fitness, yet valid assessment methods are limited, especially for individuals with severe CP. This study validated the 6-Minute Frame Running Test (6-MFRT) for assessing aerobic capacity in adolescents and young adults with CP.

Article	Year
RaceRunning training improves stamina and promotes skeletal muscle hypertrophy in young individuals with cerebral palsy. BMC musculoskeletal disorders\| PubMed ID: 32220246	2020
Multi-frequency bioimpedance: a non-invasive tool for muscle-health assessment of adults with cerebral palsy. Journal of muscle research and cell motility\| PubMed ID: 32221759	2020
Comparative analysis of power, work and muscle activation during weight-stack and iso-inertial flywheel resistance exercise in young adults with cerebral palsy. Journal of rehabilitation medicine\| PubMed ID: 32318745	2020
Athlete-Perceived Impact of Frame Running on Physical Fitness, Functional Mobility and Psychosocial Outcomes. Journal of rehabilitation medicine\| PubMed ID: 35019994	2022
Physiological Response to the 6-Minute Frame Running Test in Children and Adults With Cerebral Palsy. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association\| PubMed ID: 36067377	2022
Extracellular vesicle characteristics and microRNA content in cerebral palsy and typically developed individuals at rest and in response to aerobic exercise. Frontiers in physiology\| PubMed ID: 36620222	2022
Determinants of Frame Running Capacity in Athletes With Cerebral Palsy to Improve Training Routines and Classification Strategies: A Cross-sectional Observational Study. American journal of physical medicine & rehabilitation\| PubMed ID: 36897812	2024
Circulating immune cell populations at rest and in response to acute endurance exercise in young adults with cerebral palsy. Developmental medicine and child neurology\| PubMed ID: 38111130	2024
Validation of the 6-Minute Frame Running Test as a Cardiopulmonary Exercise Test for Adolescents and Young Adults With Cerebral Palsy. Adapted physical activity quarterly : APAQ\| PubMed ID: 40398853	2025

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