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Stretching and Progressive Resistance Exercise in Children With Cerebral Palsy: A Randomized Controlled Trial

Merete Aarsland Fosdahl1, Reidun Jahnsen, Kristin Kvalheim

  • 1Division of Pediatric and Adolescent Medicine (Mss Fosdahl and Kvalheim and Dr Jahnsen), Department of Clinical Neuroscience for Children, Oslo University Hospital, Oslo, Norway; Division of Orthopaedic Surgery (Dr Holm), Section of Research, Oslo University Hospital, Oslo University Hospital, Oslo, Norway; Faculty of Medicine (Ms Fosdahl and Drs Jahnsen and Holm), Department of Health Science, University of Oslo, Oslo, Norway.

Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association
|June 21, 2019
PubMed

Insights

This study investigated the impact of stretching and resistance exercise on children with cerebral palsy. The 16-week program showed no significant improvements in range of motion or muscle strength.

Area of Science:

  • Pediatric Physical Therapy
  • Neuromuscular Rehabilitation
  • Biomedical Engineering

Background:

  • Cerebral palsy (CP) affects motor function in children, impacting range of motion and muscle strength.
  • Limited research exists on the combined effects of stretching and progressive resistance exercise (PRE) in pediatric CP populations.
  • Optimizing physical function is crucial for improving quality of life in children with CP.

Purpose of the Study:

  • To evaluate the efficacy of a 16-week stretching and PRE program, followed by a maintenance phase, on range of motion and muscle strength.
  • To assess changes in passive and active popliteal angle and lower extremity muscle strength.
  • To determine the long-term effects of the intervention over a 32-week period.

Main Methods:

  • A randomized controlled trial involving 37 children with spastic bilateral cerebral palsy (Gross Motor Function Classification System levels I-III).
  • Intervention group received 16 weeks of targeted stretching and PRE, followed by a 16-week maintenance program.
  • Outcome measures included passive and active popliteal angles and muscle strength, assessed at baseline, 16 weeks, and 32 weeks.

Main Results:

  • After 16 weeks, the intervention group demonstrated nonsignificant improvements in passive and active popliteal angles.
  • Muscle strength assessments for quadriceps and hamstrings also showed nonsignificant gains at the 16-week mark.
  • These trends of nonsignificant improvement persisted through the 32-week evaluation.

Conclusions:

  • A 16-week stretching and PRE program, supplemented by a 16-week maintenance phase, did not yield statistically significant improvements in range of motion or muscle strength.
  • Further research may be needed to explore alternative or modified exercise protocols for this population.
  • The findings suggest that this specific exercise regimen may not be sufficient to induce significant functional changes in children with cerebral palsy.
Abstract

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