Adults with cerebral palsy: walking ability after progressive strength training

Abstract

The purpose of this study was to evaluate effects of a progressive strength training programme on walking ability in adults with cerebral palsy. Ten individuals with spastic diplegia (seven males, three females; mean age 31, range 23–44 years) participated twice a week over 10 weeks. Seven individuals with spastic diplegia (four males, three females; mean age 33, range 25–47 years) who did not receive strength training served as controls. All individuals were ambulatory but motor ability ranged from functional walkers to individuals who always required walking aids and used a wheelchair regularly. Significant improvements were seen in isometric strength (hip extensorsp=0.006, hip abductors p=0.01), and in isokinetic concentric work at 30/s (knee extensors p=0.02) but not in eccentric work. Results also showed significant improvements in Gross Motor Function Measure (GMFM) dimensions D and E (p=0.005), walking velocity (p=0.005), and Timed Up and Go (p=0.01). There was no increase in spasticity for those who underwent strength training. Individuals in the control group did not show any significant improvement in any measured variable. The groups were small, however, and there was no significant difference between the groups in any measured variable. These findings suggest that a 10‐week progressive strength training programme improves muscle strength and walking ability without increasing spasticity.

Test–retest reliability of a 1-min walk test in children with bilateral spastic cerebral palsy (BSCP)

“…A recent systematic review provided an overview of the measurement properties of WTs used within this field and concluded that the 6-min WT was the most extensively researched, best tolerated and most reflective of activities of daily living [2]. Despite the growing use of WTs as a useful outcome tool within areas of rehabilitation medicine [3][4][5][6], research regards their validity and reliability in children and adults with disability is just starting to appear within the literature. Three recent papers concluded high test-retest reliability of the 6-min protocol in adults [7] and children [8,9] with cerebral palsy (CP), although results conflicted with regards to the necessity of a practice walk.…”

Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non‐ambulant

“…[12][13][14][15][16] Most of these previous studies, however, involved ambulant young children with CP using routine exercise methods such as weightlifting and circuit training. Older young people who are non-ambulant do not have the physical ability to perform routine exercises but they may be able to pedal independently when supported on a static exercise bicycle.…”

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“…Strength training effect Although strength training was initially contraindicated because it was believed to stiffen muscles, resulting in an increase in spasticity and a decrease in range of motion (Bobath, 1971), current scientific evidence dictates the contrary (Andersson, Grooten, Hellsten, Kaping & Mattsson, 2003;Damiano, 2006;Dodd, Taylor & Damiano, 2002;Engsberg, Ross & Collins, 2006;MacPhail & Kramer, 1995). In the last decade, the strength training as part of the physical therapy has become more frequent due to the positive results of different studies (Andersson et al, 2003;Blundell, Sheperd, Dean, Adams & Cahill, 2003).…”

“…Furthermore, they also provided evidence which indicated that muscle spasticity was not deteriorated as a result of strength training in adults with CP (Andersson et al, 2003). Blundell et al (2003) carried out a training program with children with CP that consisted of a physical circuit composed of tasks such as treadmill walking, step-ups, sit-to-stands and leg presses.…”

“…In the last decade, the strength training as part of the physical therapy has become more frequent due to the positive results of different studies (Andersson et al, 2003;Blundell, Sheperd, Dean, Adams & Cahill, 2003). Firstly, it is necessary to describe the differences observed in a muscular level between people with and without CP.…”