Therapeutic effects of strengthening exercise on gait function of cerebral palsy.
Cerebral palsy is a neurological disorder, which is characterized by muscle weakness, impairment of control over muscle tone, and posture. Researchers in this study were interested in whether there is a connection between strength training and the improvement of muscle strength and tone in people with cerebral palsy. The purpose of this study was to determine the effectiveness of strengthening exercises of the lower limbs on improvement of muscle strength and gait function.
A total of 16 participants, between the ages of 4 and 12 years, were recruited for the study. Participants included those diagnosed with spastic diplegic or hemiplegic cerebral palsy (consisting of just the lower limbs) and ambulatory with or without assistive devices, which translated into a grade 2 or 3 of the Gross Motor Function Classification System (GMFCS).
The 16 participants were randomly assigned into either the control group (n=8) or the experimental group (n=9). A 5-week strengthening program was assigned to the experimental group, focusing only on the lower limb muscle groups. The program was held 3 times a week for 1 hour. Exercises consisted of a warm-up stretching exercise, squat to stand, lateral step up, stair walk up and down, isotonic exercise of lower limb muscles, isokinetic exercise utilizing a bicycle, and a cool-down exercise. Conventional physical therapy (range of motion exercises and gait training) was provided for the control group and also lasted for 5 weeks. All participants were examined for muscle tone and strength of lower limb, Gross Motor Function Measure, lateral step up, squat to stand, and three-dimensional gait analysis at pre-training, post-training, and 6-week follow up.
Analysis generally resulted in the experimental group scoring higher or better than the control group. For the experimental group, the maximal hip extensor strength and number of squat to stand increased significantly at post-training and the 6-week follow-up, while the control group did not show significant results. Also, the experimental group demonstrated a significant increase in gait speed and stride length and decrease in double support phase at post-training and 6-week follow-up. The GMFM scores D and E significantly improved in the experimental group at post-training.
Although the study showed some promising results, it did not demonstrate a significant increase of strength in the major muscle groups of the lower limbs between the two groups. However, since the program did show functional improvements of the lower limbs, the strengthening exercise program could be used to help improve gait function of individuals with spastic cerebral palsy.