Exercise interventions for cerebral palsy

Abstract

The quality of evidence for all conclusions is low to very low. As included trials have small sample sizes, heterogeneity may be underestimated, resulting in considerable uncertainty relating to effect estimates. For children with CP, there is evidence that aerobic exercise may result in a small improvement in gross motor function, though it does not improve gait speed. There is evidence that resistance training does not improve gait speed, gross motor function, participation or quality of life among children with CP.Based on the evidence available, exercise appears to be safe for people with CP; only 55% of trials, however, reported adverse events or stated that they monitored adverse events. There is a need for large, high-quality, well-reported RCTs that assess the effectiveness of exercise in terms of activity and participation, before drawing any firm conclusions on the effectiveness of exercise for people with CP. Research is also required to determine if current exercise guidelines for the general population are effective and feasible for people with CP.

Physical activity interventions for children and young people with cerebral palsy

“…Interventions with a behavioural component were identified to have the best potential to improve physical activity participation. Similar findings were published in a Cochrane Review on the effects of exercise interventions in people with CP, though the quality of evidence available is modest at best. While exercise appears to be safe for people with CP, its efficacy to improve physical activity participation and long‐term health is uncertain.…”

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

“…New trials indicate that physical activity interventions (including exercise, activity training, strength training, and behavioral change strategies) probably improve fitness [144], physical activity [142][143][144], ambulation [144], mobility [144], participation, and quality of life [142] (yellow lights, weak positive). However, they do not appear to improve gross motor skills (yellow light, weak negative) [96,144].…”

Physical therapy in Down syndrome: systematic review and meta‐analysis

“…Among the interventions, therapeutic exercise group was divided into three subgroups, according to the classification of interventions proposed by Ryan et al . () in their Cochrane review of exercise interventions in cerebral palsy. In this way, therapeutic exercise includes aerobic training (walking/jogging, exercise with an ergometer, treadmill training and treadmill training with partial body weight support), resistance training (progressive resistance training, weight‐bearing exercises, strength exercises, learning to ride a bike, conditioning and jumping training and circuit training including plyometric jumps) and mixed training (exercise programmes that include a combination of different types of interventions, e.g.…”

“…To compare the studies, it was necessary that they measured the same concept with the same instrument, in addition to applying similar interventions. Among the interventions, therapeutic exercise group was divided into three subgroups, according to the classification of interventions proposed by Ryan et al (2017)…”