Exercise programs for children with cerebral palsy: a systematic review of the literature.

The purpose of this literature review, regarding all types of exercise programs focusing on cardiovascular fitness (aerobic and anaerobic capacity) and/or lower-extremity muscle strength in children with cerebral palsy (CP), was to address the following questions: (1) what exercise programs focusing on muscle strength, cardiovascular fitness, or a combination are studied, and what are the effects of these exercise programs in children with CP? (2) What are the outcome measures that were used to assess the effects of the exercise programs? (3) What is the methodological quality of the studies?We systematically searched the literature in electronic databases up to October 2006 and included a total of 20 studies that were evaluated. The methodological quality of the included trials was low. However, it seems that children with CP may benefit from improved exercise programs that focused on lower-extremity muscle strength, cardiovascular fitness, or a combination. The outcome measures used in most studies were not intervention specific and often only focused on the International Classification of Function, Disability and Health body function and activity level. There is a need to determine the efficacy of exercise programs to improve the daily activity and participation level of children with CP and increase their self-competence or quality of life.