Functional strength and endurance training in children with cerebral palsy

Investigators: Ms Jodi Crompton, Prof Mary Galea, Ms Anne McCoy

Despite evidence of muscle weakness in children with cerebral palsy (CP), the benefits of strength training remains controversial. The aim of this pilot study was to determine the feasibility of a group-based, task-related lower limb training program and to examine the effects on the physical function of children and adolescents with CP.

Through a single-blinded, randomised controlled design, changes in the experimental group were compared with those of a control group, which undertook upper limb training tasks over the same period.   Figure 1 shows a range of tasks performed by the children in the lower limb training program. Fifteen children with CP (spastic diplegia), aged six to 14 years (mean age 10 years 6 months) were recruited through the Victorian Cerebral Palsy Register.

Parents and children found both training programs beneficial and enjoyable. Children in the experimental group demonstrated improved speed and coordination of movement during the training program itself and afterwards they could walk further in ten minutes. This trend was not demonstrated by the children in the control group. The parents' perceptions of change in their child supported these findings. Other functional abilities, as measured by the Gross Motor Function Measure (GMFM), Timed Up and Go and the 10-metre walk test, did not demonstrate change. Muscle strength of the knee extensors was also not changed following lower limb training.

This pilot study provides evidence for the feasibility of a group-based functional strength and endurance training program for children with CP. Whilst limited by the small sample size, the training program led to improvements in qualitative aspects of motor performance of children with CP, rather than increasing basic gross motor skills and peak muscle strength per se. This pilot study has also highlighted some difficulties in measuring change in the functional abilties of children with CP after physiotherapy intervention.

Figure 1.

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