Effectiveness of functional progressive resistance exercise training on walking ability in children with cerebral palsy: a randomized controlled trial.
Strength training alone makes kids stronger but does not help them walk or play more.
01Research in Context
What this study did
Kids with cerebral palsy did a 12-week circuit of leg presses, step-ups, and squats. Weights went up every week. The kids could already walk.
Researchers checked if the kids walked farther or faster after training. They also checked strength, balance, and how often the kids joined playground games.
What they found
Leg and hip muscles got stronger. Walking speed, distance, and playground time did not change.
Strength gains stayed in the gym. They did not travel to real-life walking or play.
How this fits with other research
Hutzler et al. (2013) saw the same pattern in adults with CP. Arm curls built arm strength but hand dexterity barely moved once training stopped.
Kachouri et al. (2016) got better news. Kids with intellectual disability did strength plus balance games. Strength and balance both improved. Adding a second skill, not just lifting weights, may matter.
Lin et al. (2011) used constraint therapy, not weights. Kids gained hand function and kept it six months later. Task-specific practice beat pure strength work.
Why it matters
If a gait goal is on the IEP, do not bank on progressive resistance alone. Pair strength work with walking practice, balance games, or task-specific drills. Check real-world mobility each week, not just how much weight the child can move.
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02At a glance
03Original abstract
The objective of the study was to evaluate the effectiveness of functional progressive resistance exercise (PRE) training on walking ability in children with cerebral palsy (CP). Fifty-one ambulant children with spastic CP (mean age 10 years 5 months, 29 boys) were randomized to an intervention (n=26) or control group (n=25, receiving usual care). The intervention consisted of 12 weeks functional PRE circuit training, for 3 times a week. Main outcome measures were walking ability and participation. Secondary outcomes were muscle strength and anaerobic muscle power. Possible adverse outcomes were spasticity and passive range of motion (ROM). Muscle strength increased significantly in the training group compared to the control group, but walking ability, participation and anaerobic muscle power did not change. Spasticity and ROM remained unchanged, except for a significant decrease in rectus femoris length in the intervention group. It is concluded that twelve weeks of functional PRE-training does not improve walking ability, despite improved muscle strength.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.08.026