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Isometric muscle strength and mobility capacity in children with cerebral palsy
Annet J Dallmeijer1, Eugene A Rameckers2, Han Houdijk3,4
1a Department of Rehabilitation Medicine , EMGO Institute for Health and Care Research and MOVE Research Institute, VU University Medical Center , Amsterdam , The Netherlands.
Insights
Leg muscle strength is moderately linked to mobility in children with cerebral palsy (CP). Targeted hip abductor and knee flexor training may improve function, but large gains aren't guaranteed.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Physiology
- Movement Science
Background:
- Cerebral palsy (CP) often involves impaired motor function and reduced muscle strength.
- Understanding the relationship between muscle strength and mobility is crucial for effective rehabilitation strategies in children with CP.
Purpose of the Study:
- To investigate the association between isometric leg muscle strength and various measures of mobility capacity in children with CP.
- To compare these associations with those observed in typically developing (TD) children.
Main Methods:
- Sixty-two children with CP and 47 TD children (ages 6-13) participated.
- Isometric strength of five leg muscle groups was measured using hand-held dynamometry.
- Mobility capacity was assessed via the 1-min walk, 10-m walk, sit-to-stand, lateral-step-up, and timed-stair tests.
Main Results:
- Children with CP exhibited significantly reduced isometric leg muscle strength compared to TD peers (36-82%).
- Isometric leg muscle strength explained a moderate percentage of variance in mobility capacity for children with CP (21-35%), with hip abductors and knee flexors being key contributors.
- No significant associations between leg strength and mobility were found in TD children.
Conclusions:
- Isometric leg muscle strength, particularly of hip abductors and knee flexors, is moderately correlated with mobility capacity in children with CP.
- These findings suggest that while targeted strength training may benefit mobility, the impact might be moderate.
- Further research is needed to determine the efficacy of specific strength training interventions for improving mobility in children with CP.
Purpose:
To determine the relationship between isometric leg muscle strength and mobility capacity in children with cerebral palsy (CP) compared to typically developing (TD) peers.
Method:
Participants were 62 children with CP (6-13 years), able to walk with (n = 10) or without (n = 52) walking aids, and 47 TD children. Isometric muscle strength of five muscle groups of the leg was measured using hand-held dynamometry. Mobility capacity was assessed with the 1-min walk, the 10-m walk, sit-to-stand, lateral-step-up and timed-stair tests.
Results:
Isometric strength of children with CP was reduced to 36-82% of TD. When adjusted for age and height, the percentage of variance in mobility capacity that was explained by isometric strength of the leg muscles was 21-24% (walking speed), 25% (sit-to-stand), 28% (lateral-step-up) and 35% (timed-stair) in children with CP. Hip abductors and knee flexors had the largest contribution to the explained variance, while knee extensors showed the weakest correlation. Weak or no associations were found between strength and mobility capacity in TD children.
Conclusion:
Isometric strength, especially hip abductor and knee flexor strength, is moderately related to mobility capacity in children with CP, but not in TD children. To what extent training of these muscle groups will lead to better mobility capacity needs further study. Implications for Rehabilitation Strength training in children with cerebral palsy (CP) may be targeted more specifically at hip abductors and knee flexors. The moderate associations imply that large improvements in mobility capacity may not be expected when strength increases.
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