Skip to content
Hub Nexus

Exercise as it relates to Disease, Functional Strength Training in Children with Cerebral Palsy

No author yetClaim it

Version 1Updated 8 min read

Support

This is an analysis of a journal article “Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4–8 years” by Blundell SW, Shepherd RB, Dean CM, Adams RD.[1] This has been created by u3097172 as a university assignment for the University of Canberra, unit: Health, Disease and Exercise.

What is the background to this research?

What is Cerebral Palsy?

Cerebral Palsy (CP) is a term used to identify a group of neurological disorders that effects a person’s movement and posture.[2] It occurs due to damage to the brain either before, during or after birth, when the child’s brain is under developed. It is the leading cause of physical disability in children, accounting for 1 in 500 births worldwide.[2][3] Individuals suffering from CP may experience:

  • Impaired muscle functions such as spasticity [4]
  • Low muscular strength [4]
  • And decreased motor control [4]

There are many different types of Cerebral Palsy, all effecting individuals in different ways. They can be classified by how its effects people’s movement, the severity of the effects and the body part effected.[3]
There is currently no cure for Cerebral Palsy as majority of cause associated with the malformation of the baby’s brain are unknown.[3]

Cerebral Palsy and strength training research

Image 1:Cerebral palsy (Image: The National Institutes of Health, Public domain)

Previously, strength training in children with Cerebral Palsy was perceived to be detrimental as it increased spasticity or led to greater abnormalities in movement patterns.[4] However, recent studies demonstrate that strength training, in a variety of forms, provides many benefits without adverse effects to movement.[5] Improvements in strength, mobility, flexibility, posture, functional movement (eg. Gait) and many important psychological benefits were associated with strength training in children affected.[4][5][6][7]

Where is the research from?

The current study[1] was conducted at The University of Sydney NSW. The researcher was from the Faculty of Health Sciences and worked in conjunction with the Spastic Centre of NSW. The article was published in The Journal of Clinical Rehabilitation, which is a peer reviewed journal covering the field of disability and rehabilitation

What kind of research was this?

The study was a nonrandomised ABA trial designed to determine the effects of task- specific functional strength training in children ages 4–8 years, delivered as a group circuit class. Non- randomised ABA trials aim to estimate the effectiveness of an intervention on an assigned group, measured multiple times over a particular study period. Non randomised trials are seen to have poor validity and used as observational studies, however, can be useful to identify new interventions that can be consider by trial groups in high quality studies such as RCT’s.[8]

What did the research involve?

The Subjects

The research involved a small sample size that was invited to participate in the study.[1]

  • 8 children (7 Males/ 1 Female)
  • Aged between- 4-8years with the Mean age of 6.3 ± 1.3
  • 7 Children diagnosed with spastic diplegia and 1 child diagnosed with spastic/ataxic quadriplegia

The Intervention/ The strength training

  • 4 weeks of circuit classes performed after school
  • Sessions were conducted twice weekly (total of 8 sessions all together) and lasted 1 hour each
  • Children performed functional based movements such as; walking on a treadmill, step ups, sit-to-stands, and leg presses
  • Main focuses of the strength training were; lower limb strengthening and endurance, improve segment control of lower limbs, improve motor learning and improve balance.

The measurements

  • Isometric strength test: Hips, knees ankle flexion/ extension were measured using a hand help dynamometer. The dynamometer tests were carried out on each muscle group until the child could complete 3 consistent tests, however, wouldn’t exceed 6 tests.
  • Lower extremity functional strength test: The Lateral step test was used to measure Lower extremity functional strength and overall functional strength. The test was performed over a 15 second period and the number of steps were measured.
  • Functional motor performance: The Sit-to-stand, 10m walk, 2minute walk and Nine-Hole peg test were used to measure motor performance. Using walking speed, stride length and cadence observed during the tests, total motor performance was calculated.

All measurements were assessed in 4 phases; the baseline (2weeks prior to of study), the Pre-test (start of study period), the End phase (post study period), Follow up (8 weeks post study period).[1]

Other therapy influences

All children had received previous therapy throughout childhood and prior to the beginning of study. None of the participants were involved in any other form of physiotherapy during the study term. However, during the strength session, participants were monitored by 2 supervising physiotherapists and were given individuals sessions if needed.[1]

What were the basic results?

The results demonstrate that isometric strength, functional strength and motor performance increased significantly following training and were maintained over the 8 week follow up post strength training. Increases in isometric strength were found in approximately 60% of the muscle groups tested, with a mean increase of 47% in isometric strength pre to post training. The number of lateral steps performed in 15seconds increased from 2.6-7.9 ±3.8 repetitions with limbs becoming more proportional. This demonstrates that there was an increase in Lower extremity function and strength. Finally, 10meter walking times decreased by an average of 22% due to the increase in stride length, and sit-to-stand performance increased due to the reduction of set high from 27 cm-17 cm on average. Both of these measurements indicate that motor performance increased.[1]

What conclusions should be taken away from this research?

The study identifies the strong relationship between strength training and function in children with cerebral palsy. The use of a short term strength program may provide functional benefits and lead to significant improvements in functional capacity.[1] However, The use of a non-randomised ABA trial means that this study only provides an observation between the relationship of the intervention and group.[8] In addition, the use of only one participation group, no use of a control group, the small sample size, the use of only one follow up measurement, short training term all decrease the validity of the research.[1]

What are the implications of this research?

Although the study has its limitations, it does provide the same positive result identified in other research being conducted on strength training and cerebral palsy. Strength training provides significant improvement in cerebral palsy suffers functional capacity and may be used as a component of physiotherapy.[4][5][6][7][9][10][11][12][13][14]

Further Information

References

Where this page came from

This page was imported from Wikibooks. From “Exercise as it relates to Disease” on Wikibooks, by its contributors, under CC BY-SA 4.0. Changed here: set as a page; navigation and edit links left out; each image under its own licence, credited in its caption.

Nobody has written it yet — it is the source material at a new address, which is why search engines are asked to skip it and why no one earns from it. It is up for grabs: take it on, and it is yours to rewrite and to earn from.

Comments

Spinner Logo

Read next

Next in Exercise as it relates to Disease

Exercise as it relates to Disease, Don't forget about exercise: physical activity interventions in Alzheimer's managemen
CC BY-SA 4.0
This is an analysis of the research article “Moderate-to-high Intensity Physical Exercise in patients with Alzheimer’s disease: A randomised control trial” by Hoffman et al. (2015).[1] ## What is the background to this research? Alzheimer’s disease (AD) is a form of dementia. It is a progressive deg
Exercise as it relates to Disease, Reduce falls and balance your life: is Tia Chi the answer to Parkinson's?
CC BY-SA 4.0
This Wikibooks page is a fact sheet and analysis of the journal article “tai chi and postural stability in patients with Parkinson’s Disease” by Li et al., (2012). This has been created by 3084396. ## What is the background to this research? [Parkinson's disease]( is second only to Alzheimer’s in th
Exercise as it relates to Disease, Leisure time physical activity at midlife and subsequent development of dementia and
CC BY-SA 4.0
This fact sheet is an analysis of the journal article "Leisure time physical activity at midlife and subsequent development of dementia and Alzheimer's disease" by Rovio, et al. (2005).[1] ## What is the background to this research? The aim of this study was to investigate whether leisure time physi