The effects of an exercise training program on hand and wrist strength, and function, and activities of daily living, in adults with severe cerebral palsy.
Three 90-minute weekly strength sessions boost adult CP hand power, but you must give homework or the gains vanish in two months.
01Research in Context
What this study did
Hutzler et al. (2013) ran a 12-week strength program for adults with severe cerebral palsy. The group lifted weights and used resistance bands for 90 minutes, three times a week.
Therapists tested grip, pinch, and daily-living tasks before training, after training, and again after an eight-week break.
What they found
Strength improved in five of eight tests right after the program. One dexterity test also got better.
When the adults returned eight weeks later, most gains were gone. Without practice, strength faded back to start levels.
How this fits with other research
Ortega (1978) also worked with adults with CP, but used relaxation instead of weights. Relaxation sped up pegboard moves, while strength training here boosted power. Different roads, same goal: better hand use.
Lin et al. (2011) gave kids home-based constraint therapy and saw lasting gains six months later. Their program kept parents involved, which may explain why benefits stuck, unlike the fade-out seen here.
Hung et al. (2011) used bimanual play with kids and kept gains. The adult strength program had no take-home part, so muscles lost what they learned.
Why it matters
If you run adult programs, add a short home routine to keep strength alive. Five-minute resistance band drills or weighted cups at meal time can guard against the eight-week slide. Pair strength days with relaxation or bimanual tasks to copy the longer-lasting kid models.
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02At a glance
03Original abstract
The purpose of the current study was to establish measurement reliability in adults with Cerebral Palsy (CP), and to examine the feasibility and outcomes of an upper extremity strength training program (three times per week for 90 min each time). A control group design mixed with a prospective time series design for the intervention group was completed, including a pre-test, a post-test after a 12-week intervention period, and a follow-up in the intervention group after an additional 10-week period. Seventeen adults with CP with severe motor impairment took part in the study (10 in the intervention and seven in the control group). The test battery was comprised of wrist and hand dynamometry; dominant hand upper-extremity function measures (Jebsen Hand Function Test=JHFT, Minnesota Manual Dexterity Test=MMDT, and the Nine Hole Peg Test=NHPT); and activity of daily living with the Barthel Index. The results indicated that in both the control and the intervention groups, the strength tests exhibited good-to-excellent reliability during pre-test and post-test. The group comparison revealed that while in the pre-test no between-group differences existed, in the post-test the strength training group demonstrated significantly higher values in five out of eight strength measures, as well as in the MMDT. Discontinuing the program for eight weeks reversed the effects almost to baseline. In conclusion, the outcomes demonstrated the reliability of the assessments utilized in this study, as well as the feasibility of the strength training program, in adults with severe motor impairment due to CP.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.09.015