Exercising at home improves walking ability in children with CP

A structured home-based exercise program can improve walking ability in children with cerebral palsy (CP), a new study has found. Results of the research were published in Journal of Pediatric Rehabilitation Medicine.

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Marisa Wexler MS, Cerebral Palsy News Today August 30, 2019

Physical exercise programs and therapies can be beneficial for people with CP, but participation can require dealing with numerous financial and logistical obstacles. Home-based exercise programs can sidestep some of these obstacles.

The study details results from a clinical trial in Malaysia, where 11 children with CP (seven male, four female, average age 10.25 years) participated in an eight-week, structured, home-based exercise program that was specifically designed for children with CP who are able to walk.

The program has three phases:

Phase 1	(pre-intervention), in which patients become familiar with the program and undergo physical assessments (at four weekly intervals) prior to beginning the intervention
Phase 2	(intervention), when the program is implemented at home and participants undergo physical assessments three times over eight weeks
Phase 3	(post-intervention), at which time follow-up assessments are conducted at one and three months after the intervention

The home-based program is composed of three main exercise modules for the upper and lower limb muscles: aerobic fitness training, muscle strengthening, and stretching exercises.

Motor function was measured with the gross motor function measure-66 (GMFM-66), walking ability was assessed via 6-minute walk test (6MWT), and movement efficiency was measured with the physiological cost index (PCI).

Comparing average scores before and during the intervention, 6MWT total distance increased significantly from 334 to 381 meters (365 to 416 yards), as did walking speed in this test, from 56.0 to 63.4 meters a minute (61 to 69 yards minute). After the program (Phase 3), these values decreased slightly, but still were higher than before the intervention (378 meters, or 413 yards) or Phase 1 (62.9 meters per minute, 68 yards per minute).

Similarly, average GMFM-66 scores increased significantly from before (91.88), during (93.38), and after (95.25) the program. But analysis of effect size (a statistical tool that basically determines whether two groups are different) suggested that the change in walking tests was more pronounced.

PCI scores, which evaluate movement efficiency, improved slightly, but the difference was not statistically significant.

“Overall,” the researchers wrote, “these results showed the positive effect of [the structured home-based exercise program] on the walking distance, speed and GMFM-66 score of the study participants.”

The researchers also noted that, according to logs of exercise turned in by seven of the participants, the average time for a single exercise session increased from 16.9 minutes in the second week of the program to 23.5 in the seventh week, indicating that the participants’ endurance increased over the course of the program.

This was a very small study, so further research will be needed to reinforce the results. Still, the researchers concluded that the program “is a potential, practical, and structured home-based exercise programme that can improve the walking function of children with ambulant CP.”

Marisa Wexler MS

Marisa holds an MS in Cellular and Molecular Pathology from the University of Pittsburgh, where she studied novel genetic drivers of ovarian cancer. She specializes in cancer biology, immunology, and genetics. Marisa began working with BioNews in 2018, and has written about science and health for SelfHacked and the Genetics Society of America. She also writes/composes musicals and coaches the University of Pittsburgh fencing club.

Source Cerebral Palsy News Today

References

Structured home-based exercise program for improving walking ability in ambulant children with cerebral palsy, Fauzi AA, Khayat MM, Sabirin S, Haron N, Mohamed MNA, Davis GM. J Pediatr Rehabil Med. 2019;12(2):161-169. doi: 10.3233/PRM-180538.