Meta-analysis of the effect of strengthening interventions in individuals with cerebral palsy.
Three 45-minute strength sessions per week give the biggest strength and gait boost for kids with CP.
01Research in Context
What this study did
Park et al. (2014) pooled every trial they could find on strength training for kids with cerebral palsy.
They asked: how often, how long, and how hard should we train to see real strength gains?
The team crunched numbers from many small studies to find the sweet-spot dose.
What they found
Three sessions a week, each lasting 40-50 minutes, gave the biggest strength boost.
Kids also walked faster and with better form after these programs.
Longer or more frequent workouts did not add extra benefit.
How this fits with other research
Riches et al. (2016) looked at the same set of trials but focused on muscle size instead of strength.
They saw that kids’ muscles did grow, yet they warned most studies were low quality.
Boudreau et al. (2015) reached a similar caution: every trial shows strength gains, but the methods are so different that firm rules are still shaky.
Taken together, the 2014 dose advice is the clearest number we have, even though the evidence base remains thin.
Why it matters
You can start a 45-minute, thrice-weekly resistance circuit right away. Track leg press reps and timed 10-meter walks. Stop adding days or minutes once you hit three sessions—extra time has no payoff. Use this lean schedule while we wait for bigger, cleaner trials.
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02At a glance
03Original abstract
This study aimed to investigate the evidence that strengthening interventions can improve muscle strength and activity in individuals with cerebral palsy. The search focused on studies that employed strength training for children with cerebral palsy for which six electronic databases were used to extract literature published from 2001 to 2012. The key terms used in these searches were combined strength training, strengthening, weight training, weight lifting, resistance, and cerebral palsy. The quality of each study was assessed using the PEDro (Physiotherapy Evidence Database) scale. Thirteen randomized controlled trial studies were selected and divided into categories according to program type, mode, and outcome measures. The overall effect sizes of each study and types of strengthening were large. Strengthening exercise improved muscle strength to a greater degree, when practiced 3 times per week in 40-50 min sessions than in other categories of session length, and greater improvement was observed in younger children than in older. The effect size of the activities and variables related to gait, except for gait endurance, were medium to large. The effect size of individual muscles was large, but the effect sizes for ankle plantar flexor, hip abductor/adductor, and extensor were insignificant. Strengthening interventions are useful for increasing muscle strength in individuals with cerebral palsy, specifically in youth and children, and optimal exercise consisted of 40- to 50-min sessions performed 3 times per week. Although strengthening interventions may improve activities, including gait, more studies that are rigorous are needed to determine the contributions to gross motor function.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.10.021