A multicenter, double blind, randomized controlled trial of functional strength training on gross motor function among children with spastic diplegic cerebral palsy

Abstract

IntroductionStrength training has shown benefits in rehabilitating children with spastic diplegic cerebral palsy (CP); non-functional activities are less significant in improving gross motor function. There is dearth of evidence concerning the benefits of functional strength training (FST) among children with spastic diplegic CP. Hence, we aimed to compare the benefits of FST and conventional physiotherapy (CPT) in this group.MethodsOverall, 40 children with spastic diplegic CP with Gross Motor Function Classification System levels I, II, and III were recruited by simple random sampling (Random Number Generator) to participate in this 2-group pretest-posttest, multicentre, double-blind randomized controlled study. The children were randomly divided into 2 groups: FST group and CPT group. Both groups received an active training program of 45–60 minutes for 6 weeks with a 2-month follow-up without intervention. The 88-item Gross Motor Function Measure (GMFM-88) dimensions D, E, and goal total score were recorded at baseline, after the 6-week intervention, and after the 2-month follow-up.ResultsFST group demonstrated significant differences in GMFM-88 dimensions D [7.1 (0.4–13.8); <i>p</i> = 0.038], E [11.8 (3.1–20.4); <i>p</i> = 0.009], and goal total score [9.4 (3.3–15.6); <i>p</i> = 0.003] when compared with CPT group after the 6-week intervention. Similarly, a significant difference was noted in GMFM-88 goal total score [6.3 (0.1–12.4); <i>p</i> = 0.046] after the 2-month follow-up. There were no differences in GMFM-88 dimensions D [3.9 (–2.5 to 10.5); <i>p</i> = 0.222] or E [8.6 (–0.3 to 17.4); <i>p</i> = 0.059] after the 2-month follow-up.ConclusionsSix-week FST improved standing, walking, running, and jumping in children with spastic CP. FST had a carry-over effect of strength gained in functional performance.