Strength Training May Benefit Gross Motor Function in Children With Cerebral Palsy

Strength training is associated with improvements in muscle strength, gait speed, balance, and gross motor function in children and adolescents with spastic cerebral palsy, according to study results published in Clinical Rehabilitation.

Prior research on the effects of physical training on improving functional mobility and gross motor skills has been mixed. For example, some studies have found that with muscle strengthening, muscle strength improves but not function. Other studies have reported improvement in motor activity and functions such as gait. The objective of the current study was to review the most recent data on the effect of strength training on function, activity, and participation in children and adolescents with cerebral palsy.

The meta-analysis included 27 randomized controlled trials which evaluated muscle strength training in children, adolescents, and young adults (age range, 3-22 years) with spastic cerebral palsy. In the pooled cohort of 873 patients, a total of 452 patients underwent strength training, while the remaining patients participated in a different physical therapy technique or were assigned to a control group with no physical therapy.

Researchers excluded 3 studies, yielding 24 studies in the meta-analysis. According to the researchers, there were significant standardized mean differences that were in favor of the strength training techniques vs other physical therapy techniques or control in terms of improvements in muscle strength at the knee flexors, muscle strength at the knee extensor, muscle strength at the plantar flexors, maximum resistance, balance, gait speed, Gross Motor Function Measure (global, D and E dimension), as well as spasticity.

A limitation of this meta-analysis, according to the researchers, was the high levels of moderate risk and high risk of bias among analyzed studies. Additionally, the studies in the meta-analysis did not assess the long-term effect of muscle strength training in this population. Given this limitation, the investigators noted that children with cerebral palsy should perform “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 training and should be part of a larger program that includes task-related motor skill training as well as endurance training for optimal results.”

Reference

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. Clin Rehabil. Published online August 18, 2021. doi:10.1177/02692155211040199