Effectiveness of exercise interventions for children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials

Abstract

Objective The results of previous research into exercise interventions for children with cerebral palsy are inconsistent. The aim of this study is to assess the effectiveness of such exercise interventions. Design Systematic review and meta-analysis. Methods Systematic searches of the PubMed, Embase and Cochrane Library databases for randomized controlled trials involving exercise interventions for children with cerebral palsy, from inception to January 2020, were performed. Pooled weighted mean differences (WMDs) with 95% confidence intervals (95% CI) for gross motor function, gait speed, and muscle strength were calculated using random-effects models. Results A final total of 27 trials, including 834 children with cerebral palsy, were selected for quantitative analysis. Exercise interventions had no significant effect on the level of gross motor function (WMD 1.19; 95% CI −1.07 to 3.46; p = 0.302). However, exercise interventions were associated with higher levels of gait speed (WMD 0.05; 95% CI 0.00–0.10; p = 0.032) and muscle strength (WMD 0.92; 95% CI 0.19–1.64; p = 0.013). Conclusion These results suggest that exercise interventions may have beneficial effects on gait speed and muscle strength, but no significant effect on gross motor function in children with cerebral palsy. LAY ABSTRACT Cerebral palsy is the most common cause of physical impairment in children. This study evaluated the effectiveness of exercise interventions for children with cerebral palsy. Exercise interventions were significantly associated with increased gait speed and muscle strength, while gross motor function was not affected. Exercise interventions should therefore be used for children with cerebral palsy.

Effects of Dynamic Suit Orthoses on the Spatio-Temporal Gait Parameters in Children with Cerebral Palsy: A Systematic Review

“…To date, functional gait training [21] appears to be the most effective treatment modality, whereas strength training has been proved to be less effective [22], showing additional benefits with speed training, biofeedback training, whole body vibration [23,24], virtual reality [21], electrical stimulation, and transcranial stimulation [24]. Exercise interventions also appear to have a beneficial effect on gait speed, although without significant effects on gross motor function in cwPC, which does seem to improve with aerobic exercise (although with no improvement in gait) [22] and robotic gait training [25,26]. Treadmill training in cwCP is also effective for gait speed, gait endurance [27], and limb support time, with no significant effects on cadence or stride length [28].…”

A Study on Physical Exercise and General Mobility in People with Cerebral Palsy: Health through Costless Routines

“…Promoting PA should be a priority to prevent a worsening of participants' health. RPA, whatever its intensity, has a positive effect on balance, muscle strength and gait speed [27][28][29] and has benefits proportional to the time dedication and frequency [96]. Apart from that, a person's motivation to engage in PA is essential for them to be fully involved in the activity.…”

“…Increasing RPA in individuals with CP in childhood and continuing through adolescence is key to improving morbidity and mortality rates within this population. RPA produces benefits in motor functions in children [23][24][25] and adolescents with CP [26,27] and improves gait speed [28,29], spasticity [30], balance [31] and muscle strength [27,29].…”

Skirtingų Reabilitacijos Metodų Poveikis Vaikų, Sergančių Cerebriniu Paralyžiumi, Motorinėms Funkcijoms Bei Eisenai

“…Autoriai teigia, kad būtina atlikti tolimesnius tyrimus šia tema tam, kad būtų galima išnagrinėti raumenų sinergijos panaudojimą kaip tikslą, kuriant naujas terapijas CP sergantiems vaikams [17]. X. Liang su bendraautoriais (2020) atliktoje sisteminėje apžvalgoje teigia, kad fiziniai pratimai gali turėti teigiamą poveikį CP sergančių vaikų eisenos greičiui ir raumenų jėgai, bet ne stambiosios motorikos funkcijai [18]. E. Swinnen ir kt.…”