Effects of strength-training trials for children and adolescents with spastic cerebral palsy: a systematic review

Abstract

OBJECTIVE: To evaluate the effects of strength-training on lower limb muscles and motor activity among children and adolescents with spastic Cerebral Palsy. METHODS: A comprehensive search of full text published studies in English was performed. Electronic databases were searched with no limit for year of publication. Terms used included: exercise, children, youth, disability, treatment, strength training, spastic cerebral palsy, muscle strength, training program, therapeutic exercise, gait training, and physical function. Reference lists of retrieved articles were also examined to identify additional studies. To be included, studies had to be: randomised controlled trials evaluating strength training outcomes on children and adolescents with spastic CP. Those with intellectual disability were excluded. Evaluation for quality: Trials were rated for methodological quality using the PEDro scale independently by the 2 researchers. RESULTS: Of 4 selected trials, 1 an abstract was excluded, 3 full articles were included. Trials methodological quality ranged from 6 to 8 on PEDro scale. Two studies reported significant muscle strength changes following strength training, with effect sizes ranging from d equal to 1.17 to 1.78 and another reported improved gait and perceived body image. CONCLUSION: Trials demonstrate that strength-training improves strength of targeted muscle and motor functioning. More rigorous trials on larger samples should evaluate the impact of specificity in strength-training and cost-effectiveness of programs.