Exploring the Relationship Between Physical Activity and ICF Domains in Young Adults with Cerebral Palsy: A Comparison of Unilateral and Bilateral Cases

Background/Objectives: Youths with cerebral palsy (CP) have reduced levels of physical activity (PA) due to motor impairments and functional difficulties. Few studies have observed its link with various factors and none in young adults with CP. This study aimed to investigate the relationships between PA and various factors in young adults with CP, such as gait function, endurance, participation, and personal/environmental influences. Methods: Participants over 15 years old with CP who underwent Clinical Gait Analysis (CGA), the 6 min walk test, and wore an actimeter (ActiGraph GT3X+) for seven days were included. PA was assessed by daily step count (NbSteps/day). Explanatory factors included the Gait Profile Score (GPS), walking speed, subjective walking perception, joint pain, fatigue, 6 min walk distance, SF-36 questionnaire scores, and lifestyle habits. Correlations, univariate, and multivariate regression models were used for the analysis. Results: Forty-seven CP patients (28 males, 19 females, mean age 23.6 years) were included, with 82% classified as GMFCS I and 18% as GMFCS II. The average NbSteps/day was 5685. Significant correlations were found between NbSteps/day and subjective perception, pain, GMFCS level, and walking speed. Multivariate regression identified walking speed and physiotherapy (PT) sessions as significant predictors of PA. Conclusions: PA in young adults with CP is linked to walking speed, GMFCS level, joint pain, fatigue, and PT. No differences have been observed between patient unilateral or bilateral CP. However, individual behaviors vary and are not fully explained by linear regression analysis.