Strength training in adolescent learners with cerebral palsy: a randomized controlled trial

Abstract

Objective: To evaluate the impact of an eight-week strength training program targeting multiple muscle groups using basic inexpensive free weights and resistance devices, on gait and perceptions of body image and functional competence. Design: A randomized control trial. Setting: A school for children with special needs in a disadvantaged suburb in Cape Town. Subjects: Thirty-one independently ambulant senior learners with spastic cerebral palsy (19 males, 12 females; aged 13-18 years; 15 diplegics and 16 hemiplegics). Intervention: Eight-week strength training programme in circuit format executed during school hours, one to three times per week for 40-60 min per session. Programmes were individually designed and included 8-12 exercises selected from a 28-station circuit to target upper and lower limbs and trunk. Twenty-one subjects took part in the strength training programme and were compared with 10 control subjects. Main outcome measures: Three-dimensional gait analysis and a questionnaire were used to evaluate the various parameters of gait and perceptions of body image and functional competence respectively. Results were analysed using repeated measures ANOVA and bootstrap analysis. Results: The experimental group differed significantly from the control group for measure of crouch gait (sum of the ankle, knee and hip angles at midstance) (P = 0.05) and perceptions of body image (P = 0.01). Walking velocity, cadence and stride length as well as perceptions of functional ability did not change significantly after training. Conclusion: Participation in a school-based strength training programme targeting multiple muscle groups can lead to improved degree of crouch gait and improve perception of body image.