What are the optimum training parameters of progressive resistance exercise for changes in muscle function, activity and participation in people with cerebral palsy? A systematic review and meta-regression

Abstract

ObjectivesTo explore the effect of progressive resistance exercise (PRE) on impairment, activity and participation of people with cerebral palsy (CP). Also, to determine which programme parameters provide the most beneficial effects. Data sourcesElectronic databases searched from the earliest available time. Eligibility criteriaRandomised controlled trials (RCTs) implementing PRE as an intervention in people with cerebral palsy were included. Studies appraisal & synthesis methodsMethodological quality of trials was assessed with the PEDro scale. Meta-analysis and meta-regression were completed. ResultsWe included 20 reports of 16 RCTs (n = 504 participants). Results demonstrated low certainty evidence that PRE improved muscle strength (pooled standardised mean difference (SMD)= 0.59 (95%CI: 0.16–1.01; I²=70%). This increase in muscle strength was maintained an average of 11 weeks after training stopped. Τhere was also moderate certainty evidence that it is inconclusive whether PRE has a small effect on gross motor function (SMD= 0.14 (95%CI: −0.09 to 0.36; I²=0%) or participation (SMD= 0.26 (95%CIs: −0.02 to 0.54; I²=0%). When PRE was compared with other therapy there were no between-group differences.Meta-regression demonstrated no effect of PRE intensity or training volume (frequency x total duration) on muscle strength (p > 0.5). No serious adverse events were reported. There is lack of evidence of the effectiveness of PRE in adults and non-ambulatory people with CP. ConclusionsPRE is safe and increases muscle strength in young people with CP, which is maintained after training stops. The increase in muscle strength is unrelated to the PRE intensity or dose. Contribution of the Paper•PRE increases muscle strength of people with CP•Increased muscle strength following PRE is maintained for at least 11 weeks after training stops•It is inconclusive whether or not PRE has an effect on gross motor function or participation•There is no association between the PRE dose parameters and effects on muscle strength