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Strength Training Effects on Muscle Forces and Contributions to Whole-Body Movement in Cerebral Palsy

Amy K Hegarty1, Max J Kurz2, Wayne Stuberg2

  • 1a Department of Mechanical Engineering , Colorado School of Mines , Golden , CO , USA .

Journal of Motor Behavior
|October 24, 2018
PubMed

Insights

Strength training improved isometric strength in children with cerebral palsy (CP), but did not significantly change walking speed or endurance. Simulations showed altered muscle forces, particularly from hip muscles, during gait.

Area of Science:

  • Pediatric Rehabilitation
  • Neuromuscular Disorders
  • Biomechanics

Background:

  • Strength training is a common intervention for children with cerebral palsy (CP).
  • The relationship between strength improvements and functional mobility outcomes in this population remains incompletely understood.
  • Understanding these links is crucial for optimizing therapeutic strategies.

Purpose of the Study:

  • To investigate the effects of a 6-week strength-training program on isometric strength, walking performance, and gait biomechanics in children with spastic cerebral palsy.
  • To explore the association between strength gains and changes in muscle forces during gait using musculoskeletal simulations.

Main Methods:

  • A cohort of nine children with spastic cerebral palsy (mean age 14 years, GMFCS levels I-III) participated in a 6-week progressive strength-training program.
  • Isometric joint strength, walking speed, and endurance were assessed before and after the intervention.
  • Musculoskeletal gait simulations were performed for a subset of participants to analyze muscle forces and their contribution to body center of mass acceleration during walking.

Main Results:

  • Significant increases in isometric joint strength were observed post-training.
  • No statistically significant improvements were found in fast-as-possible walking speed or endurance.
  • Gait simulations indicated alterations in muscle force generation, with hip muscles showing increased contributions to body center of mass acceleration during walking.

Conclusions:

  • Progressive strength training can lead to both isometric and dynamic strength gains in children with cerebral palsy.
  • While strength improves, the impact on functional mobility measures like walking speed and endurance can be variable.
  • The study highlights the potential for strength training to modify muscle activation patterns during gait, warranting further investigation into its functional implications.

Keywords:
biomechanicsmuscle functionmusculoskeletal modelphysical therapysimulation

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