Muscle strength and walking ability in Diplegic Cerebral Palsy: Implications for assessment and management

Thompson, Nicky; Stebbins, Julie; Seniorou, Maria; Newham, Di J.

doi:10.1016/j.gaitpost.2010.10.091

Cited by 78 publications

(72 citation statements)

References 28 publications

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“…Muscle weakness is another factor that is often discussed in relation to gait function in CP (Dallmeijer et al, 2011, Eek et al, 2011, Thompson et al, 2011. Many everyday activities allow a limited time to develop muscle force (up to 200 ms) whereas the time required to develop maximal force takes considerably longer (Aagaard et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

Geertsen

Kirk

Lorentzen

et al. 2015

Clinical Neurophysiology

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Section: Introductionmentioning

confidence: 99%

Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

Geertsen

Kirk

Lorentzen

et al. 2015

Clinical Neurophysiology

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“…Like the rest of the population, low levels of physical activity increases the risk of people with CP developing secondary health problems such as cardiovascular diseases, obesity or osteoporosis [3]. Low physical activity can also exacerbate some of the problems commonly associated with CP such as muscle weakness, stiffness and decreased mobility [4,5]. Therefore, strategies and interventions that can increase daily physical activity levels in people with CP are important.…”

Section: Introductionmentioning

confidence: 99%

The effects of progressive resistance training on daily physical activity in young people with cerebral palsy: a randomised controlled trial

Bania

Dodd

Baker

et al. 2015

Disability and Rehabilitation

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Purpose: To examine if individualised resistance training increases the daily physical activity of adolescents and young adults with bilateral spastic cerebral palsy (CP).Method: Young people with bilateral spastic CP were randomly assigned to intervention or to usual care. The intervention group completed an individualised lower limb progressive resistance training programme twice a week for 12 weeks in community gymnasiums. The primary outcome was daily physical activity ( number of steps, and time sitting and lying). Secondary outcomes included muscle strength measured with a one-repetition maximum (1RM) leg press and reverse leg press. Outcomes were measured at baseline, 12 weeks, and 24 weeks. Results:From the 36 participants with complete data at 12 weeks there were no between-group differences for any measure of daily physical activity. There was a likely increase in leg press strength in favour of the intervention group (mean difference 11.8 kg; 95%CI: -1.4 to 25.0). No significant adverse events occurred during training. Conclusions:A short-term resistance training programme that may increase leg muscle strength was not effective in increasing daily physical activity. Other strategies are needed to address the low daily physical activity levels of young people with bilateral spastic CP.3

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“…Nevertheless, there are alternative strengthening strategies that have been scarcely used in children with CP which should be considered. Eccentric strength training [46] and high velocity concentric training [37] have resulted in positive muscle alterations leading to increased strength which may be related to longitudinal muscle adaptations.…”

Section: Evaluation Of the Hypothesismentioning

confidence: 99%

“…In children with CP, this stimulus, significantly increased eccentric torque, work, and mean curve width towards normative values, meaning greater force generation through a greater ROM [26,46]. Furthermore, TD children showed an increased fascicle length more so in eccentric training as compared to concentric training [46].…”

Section: Evaluation Of the Hypothesismentioning

confidence: 99%

Relative fascicle excursion effects on dynamic strength generation during gait in children with cerebral palsy

et al. 2015

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Evaluation of muscle structure gives us a better understanding of how muscles contribute to force generation which is significantly altered in children with cerebral palsy (CP). While most muscle structure parameters have shown to be significantly correlated to different expressions of strength development in children with CP and typically developing (TD) children, conflicting results are found for muscle fascicle length. Muscle fascicle length determines muscle excursion and velocity, and contrary to what might be expected, correlations of fascicle length to rate of force development have not been found for children with CP. The lack of correlation between muscle fascicle length and rate of force development in children with CP could be due, on the one hand, to the non-optimal joint position adopted for force generation on the isometric strength tests as compared to the position of TD children. On the other hand, the lack of correlation could be due to the erroneous assumption that muscle fascicle length is representative of sarcomere length. Thus, the relationship between muscle architecture parameters reflecting sarcomere length, such as relative fascicle excursions and dynamic power generation, should be assessed. Understanding of the underlying mechanisms of weakness in children with CP is key for individualized prescription and assessment of muscle-targeted interventions. Findings could imply the detection of children operating on the descending limb of the sarcomere length-tension curve, which in turn might be at greater risk of developing crouch gait. Furthermore, relative muscle fascicle excursions could be used as a predictive variable of outcomes related to crouch gait prevention treatments such as strength training.

show abstract

Muscle strength and walking ability in Diplegic Cerebral Palsy: Implications for assessment and management

Cited by 78 publications

References 28 publications

Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

The effects of progressive resistance training on daily physical activity in young people with cerebral palsy: a randomised controlled trial

Relative fascicle excursion effects on dynamic strength generation during gait in children with cerebral palsy

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