Effect of a Combined Stretching and Strength Training Program on Gait Function in Children with Cerebral Palsy, GMFCS Level I & II: A Randomized Controlled Trial

• Main Authors: Merete Aarsland Fosdahl, Reidun Jahnsen, Kristin Kvalheim, Inger Holm
• Format: Article
• Language: English
• Published: MDPI AG 2019-06-01
• Series: Medicina
• Subjects: cerebral palsy; gait function; hamstrings stretching; progressive resistance training
• Online Access: https://www.mdpi.com/1010-660X/55/6/250

<i>Background and objectives:</i> Ambulant children with cerebral palsy (CP) often develop impaired gait, and reduced active knee extension is often a part of the problem. This study aimed to evaluate the effect of a combined intervention program including stretching and progressive resistance exercise (PRE) targeting active knee extension on gait function, in children with spastic CP. <i>Materials and methods:</i> Thirty-seven children (21 boys, 16 girls, mean age 10.2 (&#177;2.3) years), classified by Gross Motor Function Classification System I&#8722;III, were randomized to an intervention (<i>n</i> = 17) and a comparison group (<i>n</i> = 20). The intervention group received a 16-week combined exercise program (3 sessions per week) including stretching of hamstrings and PRE targeting the lower extremities, followed by a 16-week maintenance program (1 session per week). The comparison group received care as usual. Gait function was evaluated by three-dimensional gait analysis (3DGA); knee, hip and pelvic kinematics in the sagittal plane, step length and speed, Gait Deviation Index (GDI), and Six-Minute Walk test (6MWT) at 0, 16, and 32 weeks. <i>Results:</i> There were no statistically significant differences between the intervention group and the comparison group for any of the gait parameters measured at 16 and 32 weeks. There was a significant increase in gait distance measured by 6MWT within both groups; however, no differences between the groups were found. <i>Conclusion:</i> A 16-week combined stretching and PRE program followed by a 16-week maintenance program did not improve gait function in ambulant children with CP.