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Published on: August 9, 2024
A randomized clinical trial of strength training in young people with cerebral palsy
Karen J Dodd1, Nicholas F Taylor, H Kerr Graham
1Musculoskeletal Research Centre, School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Victoria, Australia. K.Dodd@latrobe.edu.au
Insights
A six-week home-based strength program significantly improved lower limb strength in young people with spastic diplegic cerebral palsy (CP). These strength gains were sustained at 12 weeks, suggesting lasting functional benefits.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Spastic diplegic cerebral palsy (CP) is a common childhood motor disorder.
- Impaired lower limb strength affects mobility and daily function in individuals with CP.
- Evidence-based interventions are needed to enhance strength and function in young people with CP.
Purpose of the Study:
- To evaluate the effectiveness of a home-based, six-week strength-training program.
- To assess the impact on lower limb strength and physical activity in young people with spastic diplegic CP.
- To determine if strength improvements are sustained after the intervention period.
Main Methods:
- Randomized clinical trial involving 21 young people (ages 8-18) with spastic diplegic CP (GMFCS levels I-III).
- Intervention group (11 participants) completed a 6-week home-based strength program.
- Control group (10 participants) received no intervention.
- Lower limb strength measured using a hand-held dynamometer; physical function assessed via Gross Motor Function Measure (GMFM) and stair climbing time.
Main Results:
- The strength-training group showed significant increases in lower limb strength at 6 weeks (p=0.046) and at 12-week follow-up (p=0.041).
- Trends indicated improvements in GMFM dimensions D (standing) and E (running, jumping) at 6 weeks.
- Faster stair climbing times were observed in the intervention group at 6 weeks.
Conclusions:
- A brief, home-based strength-training program is clinically feasible and effective.
- The program leads to significant and lasting improvements in lower limb muscle strength for young people with CP.
- These strength gains may translate to enhanced daily functional abilities in this population.
Abstract:
This randomized clinical trial evaluated the effects of a home-based, six-week strength-training programme on lower limb strength and physical activity of 21 young people (11 females, 10 males; mean age 13 years 1 month, SD 3 years 1 month; range 8 to 18 years) with spastic diplegic cerebral palsy (CP) with independent ambulation, with or without gait aids; (Gross Motor Function Classification System levels I to III). Compared with the 10 controls, the 11 participants in the strength-training programme increased their lower limb strength (combined ankle plantarflexor and knee extensor strength as measured by a hand-held dynamometer) at 6 weeks (F(1,19)=4.58, p=0.046) and at a follow-up 12 weeks later (F(1,18)=6.25, p=0.041). At 6 weeks, trends were also evident for improved scores in Gross Motor Function Measure dimensions D and E for standing, running and jumping, and faster stair climbing. A relatively short clinically feasible home-based training programme can lead to lasting changes in the strength of key lower-limb muscles that may impact on the daily function of young people with CP.
