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Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial
Author(s) -
SCHOLTES VANESSA A,
BECHER JULES G,
COMUTH ANTON,
DEKKERS HURNET,
VAN DIJK LIESEKE,
DALLMEIJER ANNET J
Publication year - 2010
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2009.03604.x
Subject(s) - cerebral palsy , medicine , spasticity , gross motor function classification system , randomized controlled trial , physical therapy , strength training , confidence interval , one repetition maximum , spastic , leg press , physical medicine and rehabilitation , muscle strength
Aim To evaluate the effectiveness of functional progressive resistance exercise (PRE) strength training on muscle strength and mobility in children with cerebral palsy (CP). Method Fifty‐one children with spastic uni‐ and bilateral CP; (29 males, 22 females; mean age 10y 5mo, SD 1y 10mo, range 6y 0mo–13y 10mo; Gross Motor Function Classification System levels I–III) were randomized to the intervention group ( n =26) or the control group ( n =25, receiving usual care). The intervention group trained for 12 weeks, three times a week, on a five‐exercise circuit, which included a leg‐press and functional exercises. The training load progressively increased based on the child’s maximum level of strength, determined by the eight‐repetition maximum. Muscle strength (measured with hand‐held dynamometry and a six‐repetition maximum leg‐press test), mobility (measured with the Gross Motor Function Measure, two functional tests, and a mobility questionnaire), and spasticity (measured by the appearance of a catch) were evaluated before, during, directly after, and 6 weeks after the end of training by two blinded research assistants. Results Directly after training, there was a statistically significant effect ( p <0.05) on muscle strength (knee extensors +12% [0.56N/kg; 95% confidence interval {CI} 0.13–0.99]; hip abductors +11% [0.27N/kg; 95% CI 0.00–0.54]; total +8% [1.30N/kg; 95% CI 0.56–2.54]; six‐repetition maximum +14% [14%; 95% CI 1.99–26.35]), but not on mobility or spasticity. A detraining effect was seen after 6 weeks. Interpretation Twelve weeks of functional PRE strength training increases muscle strength up to 14%. This strength gain did not lead to improved mobility.