Effect of functional strength training on functional motor performance in young children with cerebral palsy

The main objective of this study was to determine the effects of task-specific strength training of lower limb on functional motor performance in children with spastic cerebral palsy, and to assess the feasibility of closed kinetic chain exercise on functional motor abilities in children with cerebral palsy.

A single blinded randomized controlled intervention study consisted of two groups and three measurements, pre intervention, post intervention and follow up.

18 children with spastic diplegia among them 11 were male and 7 were female. All the subjects were received physiotherapy previously and none were allowed to attend physiotherapy other than intervention protocol.

Functional strength was assessed by Lateral step up test, functional motor performance was assessed by minimum height chair test, motor assessment scale(sit to stand item), 10 meter walk test, 2- minute walk test.

The lateral step up test of both, the left leg (p=0.002), (F=22.57) and the right leg (p=0.001), (F=44.8) demonstrated the significant improvement where as control group did not showed any such significant improvement, left leg (p=0.502), (F=0.476) and right leg (p=0.332), (F=1). Motor assessment scale – sit-to –stand item showed significant (p=0.041), (F=4.92) change pre to post training as compared to control group. Minimum height chair test score demonstrated significant improvement in intervention group (p=0.001) post training. In control group there was no such significant (p=0.88),) F=0.02) changes noted. All the gain in intervention group was maintained at follow up without any significant decline.

The result of present randomized clinical study support the view that a four week functional strength training programme consisting of weight bearing exercises functional strength of muscle of lower extremity and also improves functional motor performance such as walking, running, stair climbing, sit to stand in young children with spastic diplegic cerebral palsy, the finding are in agreement with other previous studies which have shown that functional strength training in cerebral palsy is associated with improvement in motor functions. Results of this study provides the ground for future research with a larger sample size and longer follow up and with more severe form of cerebral palsy.