Table 1, Characteristics, causes, and prevalence of multiple sclerosis, cerebral palsy, and spinal cord injury - Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury

Causes, Prevalence, and Characteristics	Cerebral Palsy	Multiple Sclerosis	Spinal Cord Injury
Etiology	Traumatic injury to a developing brain before, during, or after birth	Progressive autoimmune disease of the central nervous system with variable disease patterns; 10% primary progressive and others progressive after initial relapse and remitting course	Usually traumatic cord injury (motor vehicle accidents, falls, violence, sports); nervous system above the lesion is intact
Prevalence	1.5 to more than 4 per 1,000 live births; males 30% greater than females; 764,000 children and adults living with CP in the United States⁶	Nearly 1 million people in the United States have MS; average age onset 30 years old and females 2 to 3 times males⁷	Estimated 282,000 in the United States with SCI; recent evidence puts the average age 43 years old; 78% male⁸^,⁹
Mobility	40% limitations in walking and 30% use walkers or wheelchairs	Mobility limitations generally occur later in disease course; after 45 years of disease, on average 76% of individuals require ambulatory aid and 52% bilateral assistance¹⁰	Variable and depends on level and completeness of injury; generally stable after injury and initial rehabilitation
Associated morbidity	40% of children with CP have intellectual disability, 35% epilepsy, and more than 15% had vision impairment	Sequela of immune suppression including urinary and respiratory infections, seizures, other autoimmune diseases, visual abnormalities, ataxia¹¹	Respiratory complications, thromboembolism, autonomic dysreflexia, orthostatic hypotension, bladder dysfunction, neurogenic bowel, spasticity, pain, pressure ulcers¹²
Usual intent of physical activity	Increase mobility and overall level of function as component multimodality efforts during childhood development	Maintain mobility and attenuate limitations of progressive disease; because those with MS often have normal life expectancies the benefits of exercise for the general population would also apply	Maximize functional abilities; recreation; because long-term sequela SCI better prevented/managed, longer term health benefits of regular exercise also are relevant

Causes, Prevalence, and Characteristics

Cerebral Palsy

Multiple Sclerosis

Spinal Cord Injury

Etiology

Traumatic injury to a developing brain before, during, or after birth

Progressive autoimmune disease of the central nervous system with variable disease patterns; 10% primary progressive and others progressive after initial relapse and remitting course

Usually traumatic cord injury (motor vehicle accidents, falls, violence, sports); nervous system above the lesion is intact

Prevalence

1.5 to more than 4 per 1,000 live births; males 30% greater than females; 764,000 children and adults living with CP in the United States⁶

Nearly 1 million people in the United States have MS; average age onset 30 years old and females 2 to 3 times males⁷

Estimated 282,000 in the United States with SCI; recent evidence puts the average age 43 years old; 78% male⁸^,⁹

Mobility

40% limitations in walking and 30% use walkers or wheelchairs

Mobility limitations generally occur later in disease course; after 45 years of disease, on average 76% of individuals require ambulatory aid and 52% bilateral assistance¹⁰

Variable and depends on level and completeness of injury; generally stable after injury and initial rehabilitation

Associated morbidity

40% of children with CP have intellectual disability, 35% epilepsy, and more than 15% had vision impairment

Sequela of immune suppression including urinary and respiratory infections, seizures, other autoimmune diseases, visual abnormalities, ataxia¹¹

Respiratory complications, thromboembolism, autonomic dysreflexia, orthostatic hypotension, bladder dysfunction, neurogenic bowel, spasticity, pain, pressure ulcers¹²

Usual intent of physical activity

Increase mobility and overall level of function as component multimodality efforts during childhood development

Maintain mobility and attenuate limitations of progressive disease; because those with MS often have normal life expectancies the benefits of exercise for the general population would also apply

Maximize functional abilities; recreation; because long-term sequela SCI better prevented/managed, longer term health benefits of regular exercise also are relevant

From: Introduction

Cover of Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury

Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury [Internet].

Comparative Effectiveness Review, No. 241.

Selph SS, Skelly AC, Wasson N, et al.

Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Oct.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Table 1Characteristics, causes, and prevalence of multiple sclerosis, cerebral palsy, and spinal cord injury