Muscle strengthening is not effective in children with cerebral palsy: A systematic review

Journal article


Scianni, Aline A., Butler, Jane Margaret, Ada, Louise and Teixeira-Salmela, Luci F.. (2009) Muscle strengthening is not effective in children with cerebral palsy: A systematic review. Australian Journal of Physiotherapy. 55(2), pp. 81 - 87. https://doi.org/10.1016/S0004-9514(09)70037-6
AuthorsScianni, Aline A., Butler, Jane Margaret, Ada, Louise and Teixeira-Salmela, Luci F.
Abstract

Question: Do strengthening interventions increase strength without increasing spasticity and improve activity, and is there any carryover after cessation in children and adolescents with cerebral palsy? Design: Systematic review with meta-analysis of randomised trials. Participants: Children with spastic cerebral palsy between school age and 20 years. Intervention: Strengthening interventions that involved repetitive, strong, or effortful muscle contractions and progressed as ability changed, such as biofeedback, electrical stimulation, and progressive resistance exercise. Outcome measures: Strength was measured as continuous measures of maximum voluntary force or torque production. Spasticity was measured as velocity-dependent resistance to passive stretch. Activity was measured as continuous measures, eg, 10-m Walk Test, or using scales eg, the Gross Motor Function Measure. Results: Six studies were identified and five had data that could be included in a metaanalysis. Strengthening interventions had no effect on strength (SMD 0.20, 95% CI −0.17 to 0.56), no effect on walking speed (MD 0.02 m/s, 95% CI −0.13 to 0.16), and had a small statistically-significant but not clinically-worthwhile effect on Gross Motor Function Measure (MD 2%, 95% CI 0 to 4). Only one study measured spasticity but did not report the between-group analysis. Conclusion: In children and adolescents with cerebral palsy who are walking, the current evidence suggests that strengthening interventions are neither effective nor worthwhile.

Keywordscerebral palsy; physical therapy techniques; rehabilitation; review systematic; meta-analysis; randomised controlled trials; muscle weakness; children
Year2009
JournalAustralian Journal of Physiotherapy
Journal citation55 (2), pp. 81 - 87
PublisherAustralian Physiotherapy Association
ISSN0004-9514
Digital Object Identifier (DOI)https://doi.org/10.1016/S0004-9514(09)70037-6
Page range81 - 87
Research GroupSchool of Allied Health
Place of publicationAustralia
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