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Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in
Vanessa A Scholtes1, Jules G Becher, Anton Comuth
1Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Insights
Functional progressive resistance exercise (PRE) strength training improved muscle strength by up to 14% in children with cerebral palsy (CP). However, this 12-week intervention did not significantly enhance mobility.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, often impacting muscle strength and mobility.
- Progressive resistance exercise (PRE) is a common intervention, but its effectiveness in improving functional outcomes in children with CP requires further investigation.
Purpose of the Study:
- To assess the impact of a 12-week functional progressive resistance exercise (PRE) strength training program on muscle strength and mobility in children diagnosed with spastic cerebral palsy (CP).
Main Methods:
- A randomized controlled trial involving 51 children with spastic CP (Gross Motor Function Classification System levels I-III) assigned to either a 12-week PRE intervention group or a usual care control group.
- The PRE group engaged in a circuit of five exercises, including leg-press and functional movements, with progressively increasing training loads based on the eight-repetition maximum.
- Muscle strength, mobility, and spasticity were assessed using standardized measures before, during, immediately after, and 6 weeks post-intervention.
Main Results:
- Significant improvements in muscle strength were observed immediately after the 12-week PRE program, with gains up to 14% in the six-repetition maximum leg-press test and notable increases in knee extensors and hip abductors.
- No statistically significant improvements in mobility or spasticity were detected directly after the intervention period.
- A detraining effect on muscle strength was observed 6 weeks after the cessation of the training program.
Conclusions:
- Twelve weeks of functional PRE strength training effectively enhances muscle strength in children with CP.
- Despite significant strength gains, the functional PRE program did not translate into improved mobility in this pediatric CP population.
- Further research may be needed to explore exercise protocols that can yield improvements in mobility alongside strength gains in children with CP.
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 10 y 5 mo, SD 1 y 10 mo, range 6 y 0 mo-13 y 10 mo; 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% [0.56 N/kg; 95% confidence interval {CI} 0.13-0.99]; hip abductors +11% [0.27 N/kg; 95% CI 0.00-0.54]; total +8% [1.30 N/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.
