Effectiveness of combined endurance and strength exercise training on gross motor function and up-down stair in children with cerebral palsy

Abstract

Therapeutic exercise program have been benefit for the individual with CP. This randomized controlled trial aimed to evaluate the effectiveness of combined endurance and strength exercise training on Gross Motor Function Measurement (GMFM) and Times Up and Down Stair (TUDS) in children with CP. Fifteen subjects with spastic CP aged 13.27 ± 3.57 (range 7 to 16) years with a Gross Motor Function Classification System Expanded and Revised level I-III. They were randomly allocated into either exercise (n = 8) or control (n = 7) group. The combined exercise group performed 70 minutes/time, 3 times/week for 8 weeks. This program consisted of 1) the strength training (sit to stand and step up-down stair) to weigh progressive every 2 weeks, and 2) the endurance training: 3 stations of the stationary cycling, walking on a elliptical machine, and fast walking or running recreation. All subjects were measured the GMFM-88 and TUDS outcomes at before and after training. Analysis of covariance was used to analyze the mean difference of post-test outcomes between groups. Results were the score of GMFM-88 increased in the dimension D: standing (mean difference = 4.3%, 95%CI: 0.96 to 7.64%) and E: walking, running and jumping (mean difference = 6.71%, 95%CI: 0.48 to 12.94%) and TUDS decreased (mean difference = 6.01 seconds, 95%CI: 1.16 to 10.85 seconds) after training in the exercise group statistically (P < 0.05), when compared with the control group. This study indicated that combined endurance and strength program can improve the functional ability in mild to moderate level of the children with cerebral palsy.