Effects of a Postoperative Strength-Training Program on the Walking Ability of Children With Cerebral Palsy: A Randomized Controlled Trial

Patikas D, Wolf SI, Mund K, Armbrust P, Schuster W, Döderlein L. Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial.ObjectiveTo investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy (CP).DesignRandomized controlled trial.SettingHospital rehabilitation department.ParticipantsThirty-nine children with CP (age range, 6−16y). After orthopedic surgery, the control group (n=20) followed a conventional physiotherapy (PT) program, and the strength-training group (n=19) followed a strength-training program in addition to the conventional PT. Twenty-nine age-matched healthy children were used as references.InterventionA 9-month strength-training program.Main Outcome MeasuresSpatiotemporal, kinematic, and kinetic parameters during gait analysis were analyzed before (E0) and 1 year after (E1) the surgery. For 22 children, a 2-year postoperative gait analysis (E2) took place as well.ResultsAt E1, several kinematic and kinetic parameters improved, although there was no significant difference between the groups. Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2.ConclusionsThe examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se. However, a more significant effect of the strength-training may appear if more intense and short-term training protocols are used, considering factors such as patients’ motivations, ages, and postoperative statuses.