Effect of power training on walking abilities in children with CP with poor gross motor function

Abstract

Power training (PT) has recently been raised as a promising training modality to improve functional abilities in children with cerebral palsy (CP). Nevertheless, its effect on walking ability in CP children with poor gross motor function has never been investigated. The present study aimed to evaluate the feasibility to implement PT in an adapted school and its effect on walking abilities. Eleven children with CP [6–11 years old, Gross Motor Function Classification System (GMFCS) level I–V, including 9 children with GMFCS level III–V] were included. They were trained three times a week during 12 weeks. The training session took place during the 50-minute physical activity courses and included 20 minutes of high intensity exercise (i.e. running, fast walking with appropriated technical aids, including weight bearing walker), as well as a warm up and cool down period. Heart rate was monitored during three training sessions for each participant. A kinesiologist, a physical therapist, and the sport teacher, supervised the training sessions. Self-selected comfortable and fast walking speed, gait efficiency, as evaluated with the Energy Expenditure Index (EEI), as well as running speed were assessed before and after the training period. Ten children completed the whole training period. Participants spent 19 ± 7 min and 6 ± 7 min at an intensity superior to 40% and 60% of the heart rate reserve, respectively. The EEI was reduced after training ( P = 0.01), resulting in a more efficient gait. Comfortable and fast walking speed also increased after training ( P < 0.05). Greater improvements were observed in children with higher GMFCS level. PT is feasible in adapted school environment with children with CP with GMFCS level III–V. These data suggested that PT increases walking capacities. More studies are needed to assess the impact of PT in children with poor walking abilities.