Strength training in adolescent learners with cerebral palsy: a randomized controlled trial.

OBJECTIVE To evaluate the impact of an eight-week strength training program targeting multiple muscle groups using basic inexpensive free weights and resistance devices, on gait and perceptions of body image and functional competence. DESIGN A randomized control trial. SETTING A school for children with special needs in a disadvantaged suburb in Cape Town. SUBJECTS Thirty-one independently ambulant senior learners with spastic cerebral palsy (19 males, 12 females; aged 13-18 years; 15 diplegics and 16 hemiplegics). INTERVENTION Eight-week strength training programme in circuit format executed during school hours, one to three times per week for 40-60 min per session. Programmes were individually designed and included 8-12 exercises selected from a 28-station circuit to target upper and lower limbs and trunk. Twenty-one subjects took part in the strength training programme and were compared with 10 control subjects. MAIN OUTCOME MEASURES Three-dimensional gait analysis and a questionnaire were used to evaluate the various parameters of gait and perceptions of body image and functional competence respectively. Results were analysed using repeated measures ANOVA and bootstrap analysis. RESULTS The experimental group differed significantly from the control group for measure of crouch gait (sum of the ankle, knee and hip angles at midstance) (P= 0.05) and perceptions of body image (P= 0.01). Walking velocity, cadence and stride length as well as perceptions of functional ability did not change significantly after training. CONCLUSION Participation in a school-based strength training programme targeting multiple muscle groups can lead to improved degree of crouch gait and improve perception of body image.