Relations between muscle endurance and subjectively reported fatigue, walking capacity, and participation in mildly affected adolescents with cerebral palsy

Aim To investigate the relation between muscle endurance and subjectively reported fatigue, walking capacity, and participation in mildly affected adolescents with cerebral palsy (CP) and peers with typical development. Method In this case–control study, knee extensor muscle endurance was estimated from individual load–endurance curves as the load corresponding to a 15‐repetition maximum in 17 adolescents with spastic CP (six males, 11 females; age 12–19y) and 18 adolescents with typical development (eight males, 10 females; age 13–19y). Questionnaires were used to assess subjectively reported fatigue (Pediatric Quality of Life Inventory Multidimensional Fatigue Scale) and participation (Life‐Habits questionnaire). Walking capacity was assessed using the 6‐minute walk test. Relations were determined using multiple regression analyses. Results Muscle endurance related significantly to subjectively reported fatigue and walking capacity in adolescents with CP, while no relations were found for adolescents with typical development (subjectively reported fatigue: regression coefficient β [95% confidence intervals] for CP=23.72 [6.26 to 41.18], for controls=2.72 [−10.26 to 15.69]; walking capacity β for CP=125m [−87 to 337], for controls=2m [−86 to 89]). The 15‐repetition maximum did not relate to participation in adolescents with CP. Interpretation Subjectively reported fatigue and reduced walking capacity in adolescents with CP are partly caused by lower muscle endurance of knee extensors. Training of muscle endurance might contribute to reducing the experience of fatigue and improving walking capacity. Reduced muscle endurance seems to have no effect on participation. What this paper adds Mildly affected adolescents with cerebral palsy report more fatigue during daily life than peers with typical development. Reduced muscle endurance partly explains subjectively reported fatigue and reduced walking capacity. Reduced muscle endurance seems to have no or little effect on their high participation rates. This article is commented on by Kumar and Smith on page 789 of this issue.