A Prospective Study of Two Home Based Muscle Strengthening Programs for Children With Cerebral Palsy

Svehlik Martin, MD PhD

Status: Completed

Conditions: Cerebral Palsy

Treatments: Other: Progressive Resistance Training; Other: High Intensity Interval Training

Study type: Interventional

Funder types: Other

Identifiers

NCT02319122

26-526 ex 13/14

Details and patient eligibility

About

The aim of this randomized, stratified, single-blinded study is to compare two home based strength-training protocols (High Intensity Interval Training and Progressive Resistance Training) and their effects on muscle strength, gait and aerobic and anaerobic capacity in children with cerebral palsy.

Full description

Cerebral palsy is a common neuro-developmental disorder. Among other signs of upper motor neuron syndrome, walking pathologies and muscle weakness are leading signs of disability in children with cerebral palsy. Moreover, the gradual decline in muscle strength is part of the aging process and can be particularly devastating for people with motor disabilities. Therefore muscle-strengthening programs are indicated for children with cerebral palsy. There is evidence that lower extremity muscle strength can be increased by Progressive Resistance Training (PRT) in children with cerebral palsy. However, PRT is time consuming and therefore not always feasible for children with neurologic disorders. Moreover, it does not influence the anaerobic capacity needed for everyday activities in children. High Intensity Interval Training (HIIT) is a time efficient method, which increases both aerobic and anaerobic capacities. The aim of this randomized, stratified, single-blinded study is to compare two home based strength-training protocols (HIIT and PRT) and their effects on muscle strength, gait and aerobic and anaerobic capacity in children with cerebral palsy.

Enrollment: 22 patients

Sex: All

Ages: 8 to 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ambulatory children with unilateral or bilateral spastic cerebral palsy
• Age between 8-16 years
• Ability to accept and follow verbal instruction
• Gross Motor Function Classification System (GMFCS) at level I-II
• Willingness to participate

Exclusion criteria

• Other than spastic form of cerebral palsy (ataxia, athetoid or dystonic)
• Quadriplegia
• History of orthopaedic surgery in the last 12 months
• History of Botulinum Toxin A application in the last 6 months
• Severe mental retardation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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22 participants in 2 patient groups

Progressive Resistance Training

Other group

Description:

The key for the PRT is the timely progression of load, based on the child's individual level of strength, which ensures progressive overload. Every training session will consist of a warm up, progressive resistance exercises and a cool down period. During warm up and cool down periods.These exercises will be the same for both training groups. The strength training exercises have been chosen to strengthen the main lower extremity muscle groups which are important for the gait: sit-to-stand, lateral step-ups, the half knee rise, heel-rises and bridging. All these exercises are performed loaded according to the individual level. Three sets of 8 to 10 repetitions of each exercise will be practiced on 3 non-consecutive days with moderate velocity.

Treatment:

Other: Progressive Resistance Training

High Intensity Interval Training

Other group

Description:

The High Intensity Circuit Training is a sub form of High Intensity Interval Training. The key feature is the very little rest between the exercises which causes a consistent elevation of the participant's heart rate and a short duration of the whole exercise session. Every training session consists of a warm-up, a circuit of 5 exercises (the same as these in the PRT group) and a cool-down period. The children will be asked to train 3 times a week on non-consecutive days and to perform 3 sets. Exercise workload is controlled by determination of time intervals (30 seconds). The children will be instructed to perform as many repetitions as possible during the exercise interval and to keep the rest between the exercises short (it must not exceed 30 seconds).

Treatment:

Other: High Intensity Interval Training