According to the study results published in Clinical Rehabilitation, strength training in children and adolescents with spastic cerebral palsy is associated with improvements in muscle strength, gait speed, balance, and gross motor skills.
Previous research on the effects of physical exercise on improving functional mobility and gross motor skills has been mixed. For example, some studies have found that strengthening muscles improves muscle strength, but not function. Other studies have reported improvements in motor activity and functions such as gait. The aim of the current study was to review current data on the effect of strength training on function, activity and participation in children and adolescents with cerebral palsy.
The meta-analysis comprised 27 randomized controlled studies in which muscle strength training was investigated in children, adolescents and young adults (age group 3–22 years) with spastic cerebral palsy. In the pooled cohort of 873 patients, a total of 452 patients completed strength training, the remaining patients took part in another physiotherapy technique or were assigned to a control group without physiotherapy.
The researchers excluded 3 studies, which resulted in 24 studies in the meta-analysis. According to the researchers, there were significant standardized mean differences in favor of strength training techniques versus other physical therapy techniques or control in terms of improvements in muscle strength in the knee flexors, muscle strength in the knee extensors, muscle strength in the plantar flexors, maximum resistance, balance, gait speed, gross motor skills measurement (global, D and E dimensions) and spasticity.
According to the researchers, one limitation of this meta-analysis was the high moderate risk and the high risk of bias of the studies analyzed. In addition, the studies in the meta-analysis did not evaluate the long-term effects of muscle strength training in this population. Given this limitation, the researchers found that children with cerebral palsy “should do high-intensity strength training regularly to maintain and ideally accumulate benefits over time.”
The researchers concluded that strength training is a single “aspect of physical exercise and should be part of a larger program that includes task-based motor training as well as endurance training for optimal results.”
Merino-Andrés J, García de Mateos-López A, Damiano DL, Sánchez-Sierra A. Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis. Clinic rehab. Published online August 18, 2021. doi: 10.1177 / 02692155211040199