Abstract
Cerebral palsy is one of the main causes of disability in childhood. Resistance therapy shows benefits in increasing strength and gait in these patients, but its impact on motor function is not yet clear. The objective was to analyze the impact of resistance therapy on the improvement in the motor function using a review and meta-analysis. A comprehensive literature research was conducted in Medline (PubMed), Institute for Scientific Information (ISI) Web of Knowledge, and Physiotherapy Evidence Database (PEDro) in relation to clinical trials in which resistance therapy was used and motor function was assessed. Twelve controlled clinical trials and three non-controlled clinical trials (only one intervention arm) studies were identified. In terms of pre–post difference, the overall intra-group effect was in favor of resistance therapy intervention: standardized mean difference (SMD) = 0.37, 95% confidence interval (CI) = 0.21 to 0.52, p < 0.001 (random-effects model), with moderate heterogeneity (I2 = 59.82%). SMDs were also positive by restricting to each of the analyzed scales: SMD = 0.37, 1.33, 0.10, and 0.36 for Gross Motor Function Measure (GMFM), Lateral Step Up (LSU), Time Up and Go (TUG), and Mobility Questionnaire (MobQue) scales, respectively. Regarding the difference between groups, the results showed a high heterogeneity (I2 < 99%), with the mean difference (MD) also favorable for the GMFM scale: MD = 1.73, 95% CI = 0.81 to 2.64, p < 0.001 (random-effects model). Our results support a positive impact of resistance therapy on motor function. Further studies should delve into the clinical relevance of these results.
Highlights
Cerebral palsy (CP) is currently the most common cause of motor disability in the pediatric population
No large differences were observed, with statistically significant standardized mean difference (SMD) of 0.38 by restricting the determinations to the shorter follow-up, and 0.41 by restricting the determinations to the longer follow-up under the random-effects model
Regarding the number of sessions, the results showed a difference in favor of studies with sessions applied fewer than three days a week with an SMD of 1.59, compared to studies with sessions applied three days a week with an SMD of 0.32
Summary
Cerebral palsy (CP) is currently the most common cause of motor disability in the pediatric population. In the last 40 years, the incidence of CP increased well above 2.0 per 1000 live births in developed countries [1]. Most children with CP show a significant weakness in spastic musculature compared with the least affected. In this sense, current evidence suggests that muscle weakness in CP may contribute to disability to a greater extent than spasticity itself [2]. Res. Public Health 2019, 16, 4513; doi:10.3390/ijerph16224513 www.mdpi.com/journal/ijerph
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