Physiotherapy for Adults with Cerebral Palsy
Cerebral palsy (CP) is a lifelong condition, and many adults experience new challenges as they age, from changes in mobility, to chronic pain, fatigue, and increased risk of other health conditions. Physiotherapy plays an important role in helping people maintain health, independence, and participation in the activities that matter most.
The starting point is always person-centred care: listening to the individual, understanding what is most important to them, and setting meaningful goals. For one person, this might be improving walking endurance; for another, reducing pain, accessing the community more easily, or finding the right assistive technology to support independence. Physiotherapists, working as part of a multidisciplinary team (MDT), help turn these goals into practical, evidence-based plans.
Why Adults with CP Need Ongoing Support
Research shows that adults with CP face unique health risks and challenges compared to people without CP:
Many are sedentary for more than 75% of their waking hours, with less than 20% spent in light activity. (MDPI)
Around 25–30% of adults in their 20s and 30s already report a decline in motor function compared to childhood. (MDPI)
Adults with CP have up to three times higher risk of circulatory disease and 14 times higher risk of respiratory disease, making fitness and breathing health a priority. (Europe PMC)
Chronic pain and fatigue affect up to 80% of adults, often in multiple joints such as the back, hips, and shoulders. (Frontiers)
Spasticity, if left unmanaged, can cause contractures, stiffness, spasms, and pressure areas — all of which reduce function and independence.
Together, these challenges can contribute to loss of confidence, increased falls risk, and a cycle of inactivity. Physiotherapy aims to break that cycle by providing strategies that maintain mobility, build fitness, and support participation in everyday life.
Cardiorespiratory Training – A Priority for Health
One of the most important but often overlooked needs in adults with CP is cardiorespiratory health. Physiotherapists can support this through:
Aerobic exercise: walking, supported treadmill training, upper limb cycling, or swimming — all adapted to ability and tolerance. (Taylor & Francis Online)
Interval-based training: breaking sessions into shorter bursts to manage fatigue while still building stamina. (Taylor & Francis Online)
Respiratory muscle training: using simple handheld devices to strengthen breathing muscles, which has been shown to improve lung function in adults with CP. (ScienceDirect)
Improving cardiovascular and respiratory fitness gives people more energy for daily tasks, helps manage fatigue, and reduces long-term health risks.
Strength and Movement Training
Strength training is not just about building muscle, it’s about maintaining independence in everyday activities like standing, transferring, and walking. Although research in adults is limited, recent studies show that progressive, tailored strength programs can improve function, endurance, and confidence. (Taylor & Francis Online)
How to approach it:
Tailor exercises to the person’s abilities (resistance bands, weights, bodyweight, functional tasks)
Link sets and progression to functional goals (e.g. sit-to-stand, step negotiation)
Monitor load, fatigue, and patterns of soreness so training remains safe and sustainable
Hydrotherapy – Making Movement Easier
Hydrotherapy, or aquatic physiotherapy, offers a supportive environment where the buoyancy of water reduces joint stress and spasticity (Taylor & Francis Online). For adults with CP, research highlights benefits including:
Increased range of movement
Improved strength and endurance
Reduced pain and muscle stiffness
Better tolerance for longer or more intensive exercise sessions
Hydrotherapy also provides a safe and enjoyable way to build confidence, independence, and participation, whether that’s exercising in a therapy pool or joining community aquatic programs.
Assistive Technology – Expanding Independence
Assistive technology (AT) is more than wheelchairs. It includes any equipment that supports function, independence, and participation. Recent guidelines and reviews stress its importance for adults with CP (e.g. NICE adult CP guidance, and CP aging reviews) (MDPI) (Frontiers). Examples include:
Standing frames: to support posture, bone health, and breathing, and to reduce the risks linked with long periods of sitting.
Mobility aids and powered mobility: enabling safe, efficient access to the community and reducing fatigue.
Smart home technology: from voice-controlled lights to environmental controls, enhancing independence at home.
Physiotherapists help assess, trial, and prescribe AT, ensuring it matches each person’s goals and integrates with their daily life.
The Takeaway
Physiotherapy for adults with cerebral palsy is not one-size-fits-all. The research shows clear benefits of cardiorespiratory training, strength and movement programs, hydrotherapy, and assistive technology, but how these are used depends entirely on the individual. A person-centred, goal-directed approach, led by a physiotherapist and supported by a multidisciplinary team, helps adults with CP not only manage pain and spasticity, but also build independence, improve participation, and maintain quality of life across adulthood.
