Effects of a Postoperative Resistive Exercise Program on the Knee Extension and Flexion Torque in Children With Cerebral Palsy: A Randomized Clinical Trial

Patikas D, Wolf SI, Armbrust P, Mund K, Schuster W, Dreher T, Döderlein L. Effects of a postoperative resistive exercise program on the knee extension and flexion torque in children with cerebral palsy: a randomized clinical trial.ObjectiveTo investigate the effects of resistive exercise on the knee extension and flexion torque production during the rehabilitation period after multilevel orthopedic surgery.DesignRandomized clinical trial.SettingHospital rehabilitation department.ParticipantsThirty-nine children with spastic diplegic cerebral palsy (CP) (age range, 6–16y), randomly allocated to an exercise group (n=19) and a control group (n=20). All received conventional physiotherapy (PT), and the exercise group also followed a resistive exercise program.InterventionA 9-month standardized home-based resistive exercise program, which started about 3 months after the surgery.Main Outcome MeasuresThe Gross Motor Functional Measurement (GMFM) assessed before (E0) and 1 year (E1) after the surgery. The Modified Ashworth Scale and the isometric and isokinetic torque of the knee extensors and flexors were evaluated at E0, E1, and 6 months after the surgery.ResultsThe knee extension and flexion moments had decreased 6 months after the surgery and recovered to the preoperative level 1 year after surgery. These changes were not group dependent.ConclusionsAdditional long-term, home-based, low-cost resistive exercise that starts soon after the operation of patients with CP was not more beneficial than conventional PT only, in terms of strength and GMFM.