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Does Home-Based Progressive Resistance or High-Intensity Circuit Training Improve Strength, Function, Activity or Participation in Children With Cerebral Palsy?

      Highlights

      • This is the first prospective randomized study of high-intensity circuit training for children with cerebral palsy.
      • Home-based training is an effective extension to institutional training in children with cerebral palsy.
      • High-intensity and progressive resistance strength trainings improved specific functional parameters.
      • There was no improvement for other measures of function or participation measures.
      • Only high-intensity circuit training enhanced total muscle strength.

      Abstract

      Objective

      Does home-based progressive resistance or high-intensity circuit training improve strength, function, activity, or participation in children with cerebral palsy (CP)?

      Design

      This was the first study on high-intensity circuit training for children with CP. This study was conducted as a randomized prospective controlled pilot study.

      Setting

      Evaluation took place at the gait laboratory of the university hospital, training sessions were performed at home.

      Participants

      Children (N=22) with CP (average age: 12y, 10mo, 19 Gross Motor Function Classification System level I, 3 level II) were randomly assigned either to progressive resistance training (PRT) or high-intensity circuit training (HICT).

      Interventions

      The PRT group trained with progressive overload, while the HICT group performed as many repetitions as possible within 30-second intervals (8wk, 3 times weekly in both groups).

      Main Outcome Measures

      Outcome measures stretched over all domains of the International Classification of Functioning, Disability and Health and included muscle strength, muscle power sprint test (MPST), timed stairs test (TST), 6-minute walking test, Gait Profile Score (GPS), timed Up and Go test (TUGT) and participation questionnaires.

      Results

      Only the HICT group was able to improve strength. Furthermore, the HICT group scored better in the MPST, while PRT participants improved in the TST and TUGT. The HICT-group was able to show improvement in the subscores of the parent-reported participation questionnaire. Other measures of mobility or participation did not change.

      Conclusions

      Both programs improved function specific to intervention. However, only the HICT group showed significant strength and participation improvements. Compliance was decent in both groups, but the average training unit was shorter in the HICT group. Both exercise programs showed functional benefits, but HICT might be the preferable option for strengthening in highly functional children with CP.

      Keywords

      List of abbreviations:

      ASKp (Activity Scale for Kids Performance version), CP (cerebral palsy), GPS (Gait Profile Score), HICT (high-intensity circuit training), ICF (International Classification of Functioning, Disability and Health), MPST (muscle power sprint test), PODCI (Pediatric Outcome Data Collection Instrument), PRT (progressive resistance training), TST (timed stairs test), TUGT (timed Up and Go test)
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