Effect of Functional Progressive Resistance Exercise on Lower Extremity Structure, Muscle Tone, Dynamic Balance and Functional Ability in Children with Spastic Cerebral Palsy

Cho, Hyejin; Lee, Byoung-Hee

doi:10.3390/children7080085

Cited by 14 publications

(12 citation statements)

References 55 publications

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“…PRT had no positive nor negative effect on longitudinal muscle growth. Together with previous literature stating that PRT did not increase muscle tone or spasticity, this finding counters the notion of a potential negative influence of PRT on muscle properties for persons with spasticity (Fowler et al, 2001;Damiano et al, 2008;Scholtes et al, 2010;Stubbs and Diong, 2015;Cho and Lee, 2020). EI, on the other hand, remained unchanged for all muscles, suggesting an unaltered ratio of contractile and non-contractile muscle tissue in both groups.…”

Section: Figuresupporting

confidence: 61%

“…The duration of the training program ranged from 6 to 12 weeks. While some investigations found morphological changes after 6 weeks of PRT (Lee et al, 2015;Cho and Lee, 2020), one other study did not find such effects after 10 weeks of training (Ryan et al, 2020). The applied progressive resistance training in previous studies was either isometric, analytic or functional, whereby one previous investigation combined this resistance training with anaerobic training.…”

Section: The Challenge Of Comparing Progressive Resistance Training S...mentioning

confidence: 99%

“…Frontiers in Physiology frontiersin.org (Stackhouse et al, 2007;McNee et al, 2009;Moreau et al, 2013;Williams et al, 2013;Lee et al, 2015;Gillett et al, 2018;Kruse et al, 2019;Cho and Lee, 2020;Ryan et al, 2020). First, the age of the included participants differed between studies.…”

Section: The Challenge Of Comparing Progressive Resistance Training S...mentioning

confidence: 99%

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Progressive resistance training for children with cerebral palsy: A randomized controlled trial evaluating the effects on muscle strength and morphology

et al. 2022

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Children with spastic cerebral palsy often present with muscle weakness, resulting from neural impairments and muscular alterations. While progressive resistance training (PRT) improves muscle weakness, the effects on muscle morphology remain inconclusive. This investigation evaluated the effects of a PRT program on lower limb muscle strength, morphology and gross motor function. Forty-nine children with spastic cerebral palsy were randomized by minimization. The intervention group (nparticipants = 26, age: 8.3 ± 2.0 years, Gross Motor Function Classification System [GMFCS] level I/II/III: 17/5/4, nlegs = 41) received a 12-week PRT program, consisting of 3-4 sessions per week, with exercises performed in 3 sets of 10 repetitions, aiming at 60%–80% of the 1-repetition maximum. Training sessions were performed under supervision with the physiotherapist and at home. The control group (nparticipants = 22, age: 8.5 ± 2.1 year, GMFCS level I/II/III: 14/5/3, nlegs = 36) continued usual care including regular physiotherapy and use of orthotics. We assessed pre- and post-training knee extension, knee flexion and plantar flexion isometric strength, rectus femoris, semitendinosus and medial gastrocnemius muscle morphology, as well as functional strength, gross motor function and walking capacity. Data processing was performed blinded. Linear mixed models were applied to evaluate the difference in evolution over time between the control and intervention group (interaction-effect) and within each group (time-effect). The α-level was set at p = 0.01. Knee flexion strength and unilateral heel raises showed a significant interaction-effect (p ≤ 0.008), with improvements in the intervention group (p ≤ 0.001). Moreover, significant time-effects were seen for knee extension and plantar flexion isometric strength, rectus femoris and medial gastrocnemius MV, sit-to-stand and lateral step-up in the intervention group (p ≤ 0.004). Echo-intensity, muscle lengths and gross motor function showed limited to no changes. PRT improved strength and MV in the intervention group, whereby strength parameters significantly or close to significantly differed from the control group. Although, relative improvements in strength were larger than improvements in MV, important effects were seen on the maintenance of muscle size relative to skeletal growth. In conclusion, this study proved the effectiveness of a home-based, physiotherapy supervised, PRT program to improve isometric and functional muscle strength in children with SCP without negative effects on muscle properties or any serious adverse events.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT03863197.

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Section: Figuresupporting

confidence: 61%

Section: The Challenge Of Comparing Progressive Resistance Training S...mentioning

confidence: 99%

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Progressive resistance training for children with cerebral palsy: A randomized controlled trial evaluating the effects on muscle strength and morphology

et al. 2022

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“…Twenty-seven studies 14–40 (Figure 1) analyzed the influence of muscle strength training in children and adolescents with spastic cerebral palsy. A total of 873 subjects participated in the analyzed studies, of which 847 were diagnosed with spastic cerebral palsy and 26 subjects with no diagnosis of neurological impairments.…”

Section: Resultsmentioning

confidence: 99%

Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis

Merino-Andrés

Mateos-López²,

Damiano

et al. 2021

Clin Rehabil

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Objective: This systematic review and meta-analysis investigates the effects of strength training program in children and adolescents with cerebral palsy to improve function, activity, and participation. Data sources: Five electronic databases (MEDLINE-Pubmed, Cochrane Library, PEDro, CINAHL, and SPORTDiscus) were systematically searched for full-text articles published from inception to 30 June 2021. Review methods: Randomized controlled trials were included, who compared: (i) child population with spastic cerebral palsy population between 0 and 22 years; (ii) studies in which a muscle strength training program was performed and included dosing information; (iii) studies comparing strength training with other physical therapy technique(s) or untreated control group. Studies with similar outcomes were pooled by calculating standardized mean differences. Risk of bias was assessed with Cochrane Collaboration’s tool for assessing the risk of bias and PROSPERO’s registration number ID: CRD42020193535. Results: Twenty-seven studies, comprising 847 participants with spastic cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of strength training program compared to other physical therapy technique(s) or untreated control group(s) for muscle strength at the knee flexors, at the knee extensor, at the plantarflexors, maximum resistance, balance, gait speed, GMFM (global, D and E dimension) and spasticity. Conclusion: A strength training program has positive functional and activity effects on muscle strength, balance, gait speed, or gross motor function without increasing spasticity for children and adolescents with cerebral palsy in Gross Motor Function Classification System levels I, II, and III when adequate dosage and specific principles are utilized.

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“…In this regard, quadriceps muscles activity is required to maintain this posture (12). In addition, Cho et al in their study reported that functional progressive resistance exercise caused some positive effects by increasing lower extremity strength and morphology of quadriceps, reducing quadriceps tone, and increasing both dynamic balance and functional ability in CP spastic children (13). Therefore, this study investigated the effect of KT on quadriceps muscle on postural sway among CP children.…”

Section: Compared With Healthy Children Cp Children Principally Experience the Decreased Knee Extensor Peak Torquementioning

confidence: 97%

Immediate and Short-term Effect of Quadriceps Kinesio-Taping on Postural Sway in Children with Spastic Cerebral Palsy: A Before-After Trial

Ahmadizadeh

Aminianfar

Ayoubi

2021

Middle East J Rehabil Health Stud

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Background: Kinesio-Tape (KT) is a common method used in rehabilitation, but the KT short-term therapeutic effects on children with cerebral palsy (CP) are unclear yet. Objectives: This study aims to investigate the short-term and immediate effects of KT on postural sway in children with CP. Methods: In this before- and after-study, 27 children aged between 4 and 11 years old with spastic CP were included. Immediate and short-term effects of KT on Quadriceps muscle (QcM) were then assessed using time-up and go test (TUG) and COP (center of pressure) displacement in five assessments. Results: The results of Repeated Measure Analysis show that the short-term use of KT on QcM could reduce COP displacement in both the mediolateral and anteroposterior directions and improve the balance among children with CP (P < 0.05). Conclusions: The immediate effects of KT on the QcM did not change the COP’s displacement and balance. It was demonstrated that the short-term use of KT in QcM could improve the balance of COP and reduce its displacement.

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Effect of Functional Progressive Resistance Exercise on Lower Extremity Structure, Muscle Tone, Dynamic Balance and Functional Ability in Children with Spastic Cerebral Palsy

Cited by 14 publications

References 55 publications

Progressive resistance training for children with cerebral palsy: A randomized controlled trial evaluating the effects on muscle strength and morphology

Progressive resistance training for children with cerebral palsy: A randomized controlled trial evaluating the effects on muscle strength and morphology

Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis

Immediate and Short-term Effect of Quadriceps Kinesio-Taping on Postural Sway in Children with Spastic Cerebral Palsy: A Before-After Trial

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