Muscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review

Scianni, Aline Alvim; Butler, Jane; Ada, Louise; Teixeira-Salmela, Luci Fuscaldi

doi:10.1016/s0004-9514(09)70037-6

Cited by 152 publications

(105 citation statements)

References 33 publications

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“…Oral feeding interventions for children with CP may promote oral motor function, but these interventions have not been shown to be effective in promoting feeding efficiency or weight gain. 23 Scianni et al 24 examined muscle strengthening in children and adolescents with CP (which did not include oral motor muscles), and suggested that strengthening interventions are neither effective nor worthwhile. Although it is not possible to directly correlate approaches to interventions across body systems, these findings suggest that techniques that propose to strengthen the lip, tongue and jaw muscles that are often included in oral-motor therapy should be critically evaluated.…”

Section: Feeding/swallowing Interventions: Evidence Of Effectiveness mentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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Children with cerebral palsy (CP) are at risk for aspiration with oral feeding with potential pulmonary consequences, and commonly have reduced nutrition/hydration status and prolonged stressful meal times. There is considerable variability in the nature and severity of swallowing problems in these children whose needs change over time. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. This review is focused on dysphagia in children with CP: types of deficits, clinical and instrumental evaluation, management decision making and evidence of effectiveness of interventions.European Journal of Clinical Nutrition (2013) 67, S9-S12; doi:10.1038/ejcn.2013.224Keywords: cerebral palsy; dysphagia; pediatrics; feeding; swallowing INTRODUCTIONChildren with cerebral palsy (CP) commonly have feeding disorders and swallowing problems (dysphagia) that in many instances place them at risk for aspiration with oral feeding, with potential pulmonary consequences. They also commonly have reduced nutrition/hydration status and prolonged stressful meal times. The specific nature and severity of the swallowing problems may differ, at least to some degree, in relation to sensorimotor impairment, gross and fine motor limitations, and cognitive/ communication deficits. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits 1,2 than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. 3 Concerns are multifactorial and include issues of reduced volume of food and liquid consumed orally, nutrition deficits, inadequate hydration and limited range of textures with slow advance of oral skills.Children with moderate-to-severe dysphagia usually are managed most effectively with an interdisciplinary team that allows for multiple factors to be addressed in a coordinated way. These factors include, but are not limited to, gastrointestinal issues, pulmonary status, nutrition/hydration, oral sensorimotor skills, behavioral issues and family interactions. The importance of a structured approach is stressed to handle these multiple problems. 4 It is critical that all decisions for the management of feeding and swallowing problems are made in consideration of the primary needs of the child that is, a stable airway with adequate nutrition and hydration. In addition, any feeding/ swallowing intervention should be pleasurable and non-stressful for patients and care givers. In some instances, tube feeding may be needed either temporarily or long term. [5][6][7][8] It is expected, with rare exceptions, that these children can cope with at least minimal tastes for pleasure, a practice that may have a positive impact on management of saliva/secretions while maintaining oral function and swallowing.This review paper is focused on dysphagia: types of deficit...

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Section: Feeding/swallowing Interventions: Evidence Of Effectiveness mentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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“…This test was selected because it is one of the most popular activity outcome measures for children with CP [23,40], demonstrating a test retest reliability of 0.81 (95% confidence interval 0.65-0.90) across participants [41]. Each child did a practice walk where no data were recorded, in order to become familiarized with the procedure.…”

Section: Metermentioning

confidence: 99%

“…Specifically, strength training [18,20,21] is among the most often practiced approaches; however, in spite of gains sometimes observed in strength, the suitability of this training to promote walking in children with CP has only limited support [22,23]. Swimming and aquatic therapy have been suggested as beneficial activities for children with motor deficiencies, including those with CP, when applied at very early ages [24][25][26][27][28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Aquatic and Land-Based Training on the Metabolic Cost of Walking and Motor Performance in Children with Cerebral Palsy: A Pilot Study

Getz

Hutzler

Vermeer

et al. 2012

ISRN Rehabilitation

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Aim. To evaluate the effects of aquatic (AQ) compared to a land-based (LB) intervention programs on metabolic cost of walking (MCW), gross motor function and locomotor performance in children with cerebral palsy (CP). Methods. Eleven children with spastic diplegic CP completed this study, six in the AQ (5.2 ± 1.45 yrs) and five in the LB group (4.1 ± 1.33 yrs). MCW derived from Oxygen uptake (VO 2 ) measured with a Cosmed K4 device and walking speed at steady state. Additional measures included the 10-m test, Gross Motor Function Measure (GMFM), and Pediatric Evaluation Developmental Inventory (PEDI). Non-parametric statistics were used to analyze change in each group. Results. The AQ group significantly decreased MCW (Z = −2.2; P < .05) and increased steady state walking speed (Z = −2.2; P < .05). Both groups significantly increased 10-m walking speed (Z = −2.2; P < .03, and Z = −2.02; P < .05, resp.). The LB group exhibited moderate to large effect sizes in 10-m self-selected and fast walking speeds (Cohen's d = 1.07 and 0.73, resp.). Conclusion. Our findings suggest that Both AQ and LB programs were effective in improving 10-m speed, while the AQ training also improved the MCW of walking at steady state in children with spastic diplegic CP.

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“…Though, more research is needed to help direct clinical practice and also specific protocol of strength regime to improve the gait, but to date this analysis has not been done [24,25]. And this add to the need for this study Choosing specific set of exercise came in agreement with the assumption of Verschuren et al who calculated Inter-tester reliability of 30 second repetitions of (lateral step-ups, sit-to-stand, and standing from half kneeling)is acceptable, with intraclass correlation coefficient (ICC) values ranging from 0.91 to 0.96 in children with CP from seven to 17 years old [26].…”

Section: Citationmentioning

confidence: 99%

Can Functional Eccentric Muscle Control Remedies Balance Ability in Children with Spastic Diplegic Cerebral Palsy

Sayed¹,

Sweif²

2017

Physiother Rehabil

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Muscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review

Abstract: In children and adolescents with cerebral palsy who are walking, the current evidence suggests that strengthening interventions are neither effective nor worthwhile.

Cited by 152 publications

References 33 publications

Feeding children with cerebral palsy and swallowing difficulties

Feeding children with cerebral palsy and swallowing difficulties

The Effect of Aquatic and Land-Based Training on the Metabolic Cost of Walking and Motor Performance in Children with Cerebral Palsy: A Pilot Study

Can Functional Eccentric Muscle Control Remedies Balance Ability in Children with Spastic Diplegic Cerebral Palsy

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