OBJECTIVES: To investigate the effects of progressive resistance training of quadriceps and hamstrings muscles in children with cerebral palsy (CP). DESIGN: Pilot study using a repeated measures design with measurements at baseline, immediately after six weeks training then at four-week follow-up. SETTING: The project was undertaken within the physiotherapy department of two special schools in Glasgow. SUBJECTS: A convenience sample of eight children aged between six and 12 years, with hypertonic CP. INTERVENTION: The subjects participated three times per week in a six-week, progressive, free-weight, strengthening programme. OUTCOME MEASURES: Maximum isometric muscle strength and resistance to passive stretch were measured with a hand-held myometer. The Gross Motor Function Measure and a 10-metre timed walking test, were used to assess function and gait parameters respectively. RESULTS:Muscle strength increased, with the quadriceps to hamstrings strength ratio moving towards normal. These changes were retained at follow-up. Muscle tone decreased and continued to decrease to follow-up. The standing (D) and walking, running and jumping (E) goal areas of the Gross Motor Function Measure showed improvement that continued towards follow-up. Walking speed and step rate increased. CONCLUSIONS: A future large-scale randomized controlled study would be of value to substantiate these results as the small convenience sample and lack of control group limit this study. However, the finding that no adverse effect accompanied the positive outcomes in strength and function may encourage clinicians to consider resistance training alongside standard therapeutic interventions.
RCT Entities:
OBJECTIVES: To investigate the effects of progressive resistance training of quadriceps and hamstrings muscles in children with cerebral palsy (CP). DESIGN: Pilot study using a repeated measures design with measurements at baseline, immediately after six weeks training then at four-week follow-up. SETTING: The project was undertaken within the physiotherapy department of two special schools in Glasgow. SUBJECTS: A convenience sample of eight children aged between six and 12 years, with hypertonic CP. INTERVENTION: The subjects participated three times per week in a six-week, progressive, free-weight, strengthening programme. OUTCOME MEASURES: Maximum isometric muscle strength and resistance to passive stretch were measured with a hand-held myometer. The Gross Motor Function Measure and a 10-metre timed walking test, were used to assess function and gait parameters respectively. RESULTS: Muscle strength increased, with the quadriceps to hamstrings strength ratio moving towards normal. These changes were retained at follow-up. Muscle tone decreased and continued to decrease to follow-up. The standing (D) and walking, running and jumping (E) goal areas of the Gross Motor Function Measure showed improvement that continued towards follow-up. Walking speed and step rate increased. CONCLUSIONS: A future large-scale randomized controlled study would be of value to substantiate these results as the small convenience sample and lack of control group limit this study. However, the finding that no adverse effect accompanied the positive outcomes in strength and function may encourage clinicians to consider resistance training alongside standard therapeutic interventions.
Authors: Ragab K Elnaggar; Mohammed F Elbanna; Waleed S Mahmoud; Bader A Alqahtani Journal: J Musculoskelet Neuronal Interact Date: 2019-12-01 Impact factor: 2.041