To do or not to do (exercise) : physical activity in the lives of people with cerebral palsy

Abstract

We examined the lives of adults with cerebral palsy who had minimal involvement in physical activity (Judy, aged 60; Alana, aged 29), who were involved in physical activity (Amy, aged 25; Ben, aged, 30), or who had minimal involvement in physical activity and who then participated in physical activity (David, aged 27; Tim, aged, 24). After receiving ethical approval, a life-history research approach (Denzin, 1989: Interpretive biography. Newbury Park, CA: Sage) was used, with the participants&rsquo; stories being interpreted using primarily psychodynamic theory (Freud, Erikson, Adler, Basch) to gain insight into their meaning and experiences of physical activity. Judy and Alana had similar childhood experiences, which included: performing difficult, and sometimes painful, physiotherapy; wearing callipers to assist their walking; lacking competence at physical activity; and being socially isolated from their classmates. These aspects of their life histories seemed to contribute to their subsequent avoidance of physical activity and early onset of functional decline.Amy and Ben had negative experiences with physical activity as children (similar to Judy and Alana), but were involved in, and valued, physical activity as adults. Physical activity was a means of displaying competence, delaying further functional loss, and becoming socially connected.David and Tim lost the ability to walk in early adolescence. The minimal physical activity in which they engaged during their adult lives was directed towards trying to walk again. Walking seemed to be intimately connected with psychosocial growth. David&rsquo;s weight-training programme seemed to provide him with another avenue for self-improvement towards his goal of attracting a life partner. Tim&rsquo;s warm-water aerobic programme provided him with an opportunity to develop competence at swimming and at walking, and to enhance his self-esteem for these activities.Involvement in physical activity may be important for people with cerebral palsy in their endeavours to successfully face the various psychosocial challenges throughout life. Implications of this research include: parents and teachers of children with cerebral palsy should provide support for their involvement in physical activity; physiotherapists should try to reduce the pain and increase the perceived relevancy of the treatments they deliver to young people with cerebral palsy; and psychologists should be aware of some of the difficulties people with cerebral palsy face and how they may manifest in adults with the condition.<br /