Power training helps children with CP meet mobility goals

A power-training program aimed at improving the function of children with cerebral palsy helped them meet mobility goals, a Dutch study reported.

Daniel Ferreira is representing Canada at the World Bench Only Powerlifting Competition in Helsinki, Finland this month. The 15 year old was introduced to the sport through the Grandview Children’s Centre and now holds a Canadian record for para bench press. Sabrina Byrnes, Metroland. Toronto Star May 8, 2018

By Stacy Grieve, Cerebral Palsy News Today March 19, 2018

The study [1] was published in the European Journal of Physical and Rehabilitation Medicine.

In a previous study,[2] researchers from the University Medical Center in Amsterdam used the power-training program they developed [3] to increase lower-limb muscle strength and walking capacity in children with cerebral palsy.

Because mobility limitations often prevent children with the disorder from actively participating in school and family activities, the team wanted to know if the program would enable the children to meet specific mobility goals.

Twenty-two children, aged 4-10 years, and their parents took part in the study. Researchers asked the parents to track whether the children were able to meet their goals. The team compared children’s ability to meet goals while receiving normal care for 14 weeks with their ability to meet goals while taking power training for 14 weeks.

The children took power training three times a week for 60 minutes at a time. Each session consisted of a warm-up phase, three to four power exercises, and a game. Exercises included running, walking,  pushing a chair, climbing stairs, propelling a scooter, and walking sideways while carrying weight.

To keep the children motivated, the trainers created a super-hero story and secret missions.

In addition to a goal achievement scale, researchers looked at changes in the children’s Functional Mobility Scale scores and in their parent-reported Mobility Questionnaire scores.

After power-training, 86% of children achieved or exceeded their goal, compared with only 14% during the normal care period.

Power training also enabled children to walk longer distances, parents reported.

The Functional Mobility Scale rates a child’s walking ability at three distances — five, 50 and 500 yards. The three represent mobility at home, at school and in the community. The scale takes into account different assistive devices that a child uses in different environments.

No significant differences were found between the normal-care and power-training periods for distances of five or 50 meters, since, in general, children score high on their ability to walk these distances unassisted. But the chance of a child improving their score by 1 or more on the Functional Mobility Scale at 500 meters was 10 times higher after power training.

Another important finding was that children’s scores on the parent-reported Mobility Questionnaire scale were much better after power training.

“The results indicated that functional power-training is an effective training to achieve personalized treatment goals for activities in daily life and parent-reported mobility performance in young children with cerebral palsy,” the researchers wrote.

Source Cerebral Palsy News Today

  1. Improved parent-reported mobility and achievement of individual goals on activity and participation level after functional power-training in young children with cerebral palsy: a double-baseline controlled trial, van Vulpen LF, de Groot S, Rameckers EA, Becher JG, Dallmeijer AJ. Eur J Phys Rehabil Med. 2018 Oct;54(5):730-737. doi: 10.23736/S1973-9087.18.04921-3. Epub 2018 Mar 7. Full text
  2. Improved Walking Capacity and Muscle Strength After Functional Power-Training in Young Children With Cerebral Palsy, van Vulpen LF, de Groot S, Rameckers E, Becher JG, Dallmeijer AJ. Neurorehabil Neural Repair. 2017 Sep;31(9):827-841. doi: 10.1177/1545968317723750. Epub 2017 Aug 8.
  3. Effectiveness of Functional Power Training on Walking Ability in Young Children With Cerebral Palsy: Study Protocol of a Double-Baseline Trial, van Vulpen LF, de Groot S, Rameckers EAA, Becher JG, Dallmeijer AJ. Pediatr Phys Ther. 2017 Jul;29(3):275-282. doi: 10.1097/PEP.0000000000000424.
  Further reading
  1. The effect of combined functional anaerobic and strength training on treadmill gait kinematics and kinetics in ambulatory young adults with cerebral palsy, Gillett JG, Lichtwark GA, Boyd RN, Carty CP, Barber LA. Gait Posture. 2019 May;70:323-329. doi: 10.1016/j.gaitpost.2019.03.023. Epub 2019 Mar 25.
  2. Lower limb strength training in children with cerebral palsy–a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles, Scholtes VA, Dallmeijer AJ, Rameckers EA, Verschuren O, Tempelaars E, Hensen M, Becher JG. BMC Pediatr. 2008 Oct 8;8:41. doi: 10.1186/1471-2431-8-41. Full text
  3. Change in basic motor abilities, quality of movement and everyday activities following intensive, goal-directed, activity-focused physiotherapy in a group setting for children with cerebral palsy, Sorsdahl AB, Moe-Nilssen R, Kaale HK, Rieber J, Strand LI. BMC Pediatr. 2010 Apr 27;10:26. doi: 10.1186/1471-2431-10-26. Full text
  4. Functional strength training in child with cerebral palsy GMFCS IV: case report, Dos Santos AN, da Costa CS, Golineleo MT, Rocha NA. Dev Neurorehabil. 2013 Oct;16(5):308-14. doi: 10.3109/17518423.2012.731085. Epub 2013 Apr 25.
  5. Self-care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications, Öhrvall AM, Eliasson AC, Löwing K, Ödman P, Krumlinde-Sundholm L. Dev Med Child Neurol. 2010 Nov;52(11):1048-55. doi: 10.1111/j.1469-8749.2010.03764.x. Epub 2010 Aug 16. Full text
  6. The Functional Mobility Scale (FMS), Graham HK, Harvey A, Rodda J, Nattrass GR, Pirpiris M. J Pediatr Orthop. 2004 Sep-Oct;24(5):514-20.

Also see
Oshawa teen headed to Finland for world powerlifting competition The Toronto Star
Heartland man with cerebral palsy inspires others in his quest to walk WOWT NBC News
Functional Mobility Scale Shirley Ryan AbilityLab

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