Functional fitness training in children and adolescents with cerebral palsy: a randomized controlled trial
O VERSCHURAN BSC PT A,B,C , M KETELAAR PHD A,C,D , T TAKKEN
MSC PHD B, P JM HELDERS MSC PHD PCS PROFESSOR B, J WILLEM GORTER MD PHD A,B,C,D
- 1. Rehabilitation Centre `De Hoogstraat’;
- 2. University Children’s Hospital and Medical Centre, Department of Pediatric
- 3. Physiotherapy and Exercise Physiology;
- 4. Partner of NetChild, Network for Childhood Disability Research;
- 5. Rudolf Magnus Institute of Neuroscience , Utrecht, the Netherlands
Objectives: To evaluate the effects of a standardized functional fitness programme in children and adolescents with cerebral palsy (CP).
Design: Randomized controlled multicenter trial.
Setting: Four schools for special education.
Participants: In total, 65 children with CP (41 males, 24 females; age range 7-18y) classified at Levels I or II of the Gross Motor Function Classification System (GMFCS) participated in this study.
Method: Participants were randomly allocated to either the training group (TG; n=32) or control group (CG; n=33). Children in the CG received their usual care, whereas children in the TG received the fitness programme in addition to their usual care.
The programme was standardized and all training sessions took place during school hours. The TG met twice per week, for 8 months. Each training session consisted of a 5- minute warm-up, 25 to 35 minutes of functional aerobic, anaerobic, and muscle strengthening exercises (such as running and changing direction of the body abruptly, step-ups, and negotiating stairs) in circuit format, and a 5-minute cool down. The following outcomes were assessed before, during, and after the programme: aerobic capacity (10m shuttlerun test), anaerobic muscle power (muscle power sprint test), agility (10x5m sprint test), and functional muscle strength (30s repetition maximum). Participants was measured using the Children’s Assessment of Participation and Enjoyment (CAPE), and quality of life was measured using the TNO AZL Child Quality of Life (TACQOL)-Parent Form.
A repeated-measures analysis of variance was used for each variable to determine the differences between the TG and CG from pre-treatment to follow-up. Statistical significance was set at 0.05.
Results: A significant `groupxtime’ interaction in favour of the TG was found on aerobic capacity, anaerobic muscle power, agility, and functional muscle strength. The CAPE showed a similar interaction effect for the formal, overall, and skilled-based activities domains. On the TACQOL-Parent Form a significant interaction was found for the Motor, Autonomy, Cognition, and Social domains.
Conclusions: Children with CP following an 8-month functional fitness training programme significantly improved in comparison with children receiving usual care with respect to physical fitness levels as well as to participation and quality of life.