Abstract
Dodd KJ, Taylor NF, Damiano DL. A systematic review of the effectiveness of strength-training
programs for people with cerebral palsy. Arch Phys Med Rehabil 2002;83:1157-64. Objective: To determine whether strength training is beneficial for people with cerebral palsy
(CP). Data Sources: We used electronic databases to find trials conducted from 1966 though 2000; key
words used in our search were cerebral palsy combined with exercise, strength, and physical training. We supplemented this search with citation tracking. Study Selection: To be selected for detailed review, reports found in the initial search were assessed
by 2 independent reviewers and had to meet the following criteria: (1) population
(people with CP), (2) intervention (strength training or a progressive resistance
exercise program), and (3) outcomes (changes in strength, activity, or participation).
Of 989 articles initially identified, 23 were selected for detailed review. Data Extraction: Empirical studies were rated for methodologic rigor with the PEDro Scale, and studies
with a PEDro score of less than 3 were excluded. Review articles were evaluated for
quality with the National Health Service Centre for Reviews and Dissemination form.
Data Synthesis: Of the 23 selected articles, 11 studies (10 empirical, 1 review) met the criteria
for quality and were included. Only 1 randomized controlled trial was identified.
With respect to impairment, 8 of the 10 empirical studies reported strength increases
as a result of a strength-training program, with effect sizes ranging from d equal to 1.16 (95% confidence interval,.11–2.21) to d equal to 5.27 (95% CI, 4.69–5.05). Two studies reported improvements in activity,
and 1 study reported improvement in self-perception. No negative effects, such as
reduced range of motion or spasticity, were reported. There was insufficient evidence
from which to draw conclusions about the effects of environmental and personal contextual
factors. Conclusions: The trials suggest that training can increase strength and may improve motor activity
in people with CP without adverse effects. More rigorous studies are needed that have
a greater focus on changes in activity and participation and that consider contextual
factors. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article info
Footnotes
☆Reprint requests to Karen Dodd, PhD, Schl of Physiotherapy, La Trobe University, Bundoora 3086, Victoria, Australia, e-mail: [email protected]
☆☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Copyright
© 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
