Effects of a Postoperative Strength-Training Program on the Walking Ability of Children With Cerebral Palsy: A Randomized Controlled Trial

Abstract 

Patikas D, Wolf SI, Mund K, Armbrust P, Schuster W, Döderlein L. Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial.

Objective

To investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy (CP).

Design

Randomized controlled trial.

Setting

Hospital rehabilitation department.

Participants

Thirty-nine children with CP (age range, 6−16y). After orthopedic surgery, the control group (n=20) followed a conventional physiotherapy (PT) program, and the strength-training group (n=19) followed a strength-training program in addition to the conventional PT. Twenty-nine age-matched healthy children were used as references.

Intervention

A 9-month strength-training program.

Main Outcome Measures

Spatiotemporal, kinematic, and kinetic parameters during gait analysis were analyzed before (E0) and 1 year after (E1) the surgery. For 22 children, a 2-year postoperative gait analysis (E2) took place as well.

Results

At E1, several kinematic and kinetic parameters improved, although there was no significant difference between the groups. Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2.

Conclusions

The examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se. However, a more significant effect of the strength-training may appear if more intense and short-term training protocols are used, considering factors such as patients’ motivations, ages, and postoperative statuses.

Key Words:  Cerebral palsy , Exercise , Gait , Rehabilitation , Surgery