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Changing Practice: Clinical Application of Resistance Training Evidence for Children With Cerebral Palsy
James B Hedgecock1, Nicole M Harris, Mary Jane Rapport
1Department of Physical and Occupational Therapy (Dr Hedgecock and Ms Harris), Children's Hospital Colorado, Aurora, Colorado; Hedgecock Physical Therapy PLLC (Dr Hedgecock); Denver, Colorado; Physical Therapy Program (Dr Rapport), Hawai'i Pacific University, College of Health and Society, Honolulu, Hawaii.
Insights
Progressive resistance exercise (PRE) improves function and participation in children with cerebral palsy (CP). A new guideline facilitated the adoption of PRE as a standard care model, leading to positive outcomes.
Area of Science:
- Pediatric Rehabilitation
- Clinical Practice Guidelines
- Exercise Science
Background:
- Muscle structure and performance significantly influence functional abilities and participation in children with cerebral palsy (CP).
- Progressive resistance exercise (PRE) is increasingly recognized as an effective intervention for addressing these impairments.
- A growing body of evidence supports the use of PRE to achieve functional and participation goals in pediatric populations.
Purpose of the Study:
- To describe the development and implementation of a progressive resistance exercise (PRE) program for children with cerebral palsy (CP).
- To establish this PRE program as a standard care model within an urban specialty hospital network.
- To provide a framework for translating evidence into clinical practice for pediatric CP management.
Main Methods:
- Development of a novel clinical guideline focused on individualized, goal-focused PRE dosing.
- Implementation of professional development programs for clinicians.
- Establishment of program monitoring and outcome measure utilization.
- Translating existing evidence into a practical, standardized clinical protocol.
Main Results:
- Successful integration of a PRE program into standard care for children with CP.
- Demonstrated positive impacts on child function and participation outcomes.
- Facilitation of practice change through evidence-based guideline implementation.
Conclusions:
- Translating evidence into practice through a clinical guideline effectively achieved positive child function and participation outcomes.
- The developed PRE program serves as a model for addressing goal-related muscle performance impairments in children with CP.
- Clinicians should consider incorporating goal-specific PRE into physical therapy interventions for children with CP.
Purpose:
Describe the development and application of a progressive resistance exercise (PRE) program for children with cerebral palsy (CP), which became a standard care model at an urban specialty hospital network.
Summary Of Key Points:
Muscle structure and performance have been shown to impact function and participation in children with CP. Use of PRE to achieve function and participation goals is supported by a growing body of evidence. A novel guideline, focused on individualized, goal-focused PRE dosing, professional development, program monitoring, and outcome measures use, facilitated application of a new clinical practice.
Conclusions:
Practice change was accomplished by translating evidence using a clinical guideline resulting in positive child function and participation outcomes.
Recommendations For Clinical Practice:
This Special Communication provides an example of addressing goal-related muscle performance impairments in children with CP. Clinicians should consider updating long-standing physical therapy intervention strategies by incorporating goal-specific PRE into practice.
