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. Trial registration number ACTRN12616000326493. Data are available on reasonable request.

中文翻译：

---

残疾人运动的力量：以表现为中心的游泳训练对脑瘫和高支持需求青少年运动功能的影响（GMFCS IV）——单例实验设计，随访 30 个月


目的 本研究旨在评估以表现为中心的游泳计划对先前未经训练的脑瘫和高支持需求 (CPHSN) 青少年运动功能的影响，并确定这些游泳运动员是否出现 CPHSN 青少年典型的运动衰退。方法 进行了一项多基线、单病例实验设计 (MB-SCED) 研究，包括五个阶段和 30 个月的随访。参与者为两名男性和一名女性，年龄均为 15 岁，未经培训且持有 CPHSN。干预措施是为期 46 个月的游泳训练计划，专门致力于提高表现。结果是游泳表现（速度）；训练负荷（感知用力程度（分钟/周；游泳距离/周）和粗大运动功能测量 66 项集 (GMFM-66)。 MB-SCED 数据使用中断时间序列模拟分析进行分析。使用 GMFM-66 评分对 46 个月的运动功能进行建模（广义加性模型），并与预测运动衰退的模型进行比较。结果 GMFM-66 分数对训练的反应显着改善 (p<0.001)，并且两个阶段的训练退出均导致运动能力显着下降 (p≤0.001)。在研究期间，参与者的运动功能保持在基线水平以上，而且重要的是，参与者没有经历其他患有 CPHSN 的青少年典型的运动衰退。每周训练量也符合世卫组织建议的身体活动水平。结论 结果表明，患有 CPHSN 的青少年通过参加竞技游泳来满足体力活动指南可以预防运动能力下降。 然而，这一人群在临床上很复杂，为了能够安全、有效地参与竞技体育，应优先考虑开发由熟练的多专业团队提供的项目。试用注册号ACTRN12616000326493。可根据合理要求提供数据。