Article

Children with spastic cerebral palsy (CP) have small, weak muscles. However,
change in muscle size due to resistance training in this group is unknown. We
investigated the effect of plantarflexor strengthening on muscle volume, gait,
and function in 13 ambulant children with spastic CP (seven males, six females;
mean age 10 y 11 mo, SD 3 y 0 mo, range 6 y 11 mo-16 y 11 mo; eight with
diplegia, five with hemiplegia; Gross Motor Function Classification System level
I, six; level II, five; level III, two). Assessments were performed before
training, 5 and 10 weeks into training, and at a 3-month follow-up. Medial and
lateral gastrocnemius volumes were computed from three-dimensional ultrasound
images. The number of unilateral heel raises able to be achieved on each side was
assessed. Function was measured using three-dimensional gait analysis, the 'timed
up and go' test, the Gillette Functional Assessment Questionnaire, and the
Functional Mobility Scale. Training involved heel raises or Thera-Band
resistance, 4 times a week for 10 weeks. Medial and lateral gastrocnemius volumes
increased by 17 and 14% at week 5 (p=0.03, p=0.028). This increase was maintained
at week 10 and follow-up (medial gastrocnemius p=0.001, p<0.001; lateral
gastrocnemius p=0.006, p=0.007). Heel raises (mean number) increased by week 5
(p=0.002). This was maintained at week 10 and follow-up (p<0.001; p<0.001). No
significant change in measured function was observed. Muscle volume increased in
response to training in children with spastic CP. The role of progressive
strength training in maintaining long-term function is discussed.

Langue : ANGLAIS