CP-EXCEL: A feasibility randomised controlled trial of an online exercise programme for adults with cerebral palsy [version 3; peer review: 2 approved]

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Introduction Adults with cerebral palsy (CP) are at increased risk of non-communicable diseases and often experience secondary complications as they age. Physical activity can mitigate these risks and improve well-being. However, adults with CP face significant challenges in accessing structured, tailored exercise programmes due to limited service availability and environmental barriers. A group online exercise programme may overcome some of the barriers to accessing exercise faced by adults with CP. CP-EXCEL aims to evaluate the feasibility of an online exercise programme for adults with CP. The study will examine the demand, implementation, practicality, adaptability, acceptability, and potential efficacy of delivering the online exercise programme to adults with CP in Ireland. Methods This feasibility randomised controlled trial will recruit 60 adults with CP. Participants will be randomly assigned to either an eight-week online exercise intervention or a control group. The feasibility of the programme will be evaluated across five key domains: 1) demand as indicated by recruitment rate; 2) implementation as indicated by attendance; 3) practicality as indicated by number and type of adverse events; 4) adaptability, by examining how the programme accommodates varying levels of mobility and associated impairments; and 5) acceptability explored through semi-structured interviews with participants. To assess preliminary efficacy, the Patient-Reported Outcomes Measurement Information System (PROMIS) will be used to measure changes in physical, mental, and social functioning at baseline and post-intervention. Quantitative outcomes will be analysed using linear mixed models, and qualitative data will be analysed using framework analysis. Conclusion This study will provide valuable insights into the feasibility of an online exercise programme tailored for adults with CP And inform the design of a future fully powered randomised controlled trial.

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