Physical activity and exercise have been an important aspect of cerebral palsy treatment plans for several decades. However, it is only in recent years, that researchers realized the importance of strength training for people with cerebral palsy. Studies indicate that strength training has the potential to improve several aspects of life by increasing mobility and strength. With cerebral palsy month just around the corner, it is fitting to take a closer look at how strength training can help people living with cerebral palsy.
The Benefits of Strength Training in People with Cerebral Palsy
Reduces muscle weakness
For people living with cerebral palsy, muscle weakness of the arm and hand can make it difficult to complete everyday activities such as getting dressed, bathing or even using cutlery. Furthermore, this muscle weakness often co-exists with spasticity (stiffness) and dyskinesia (involuntary muscle movements). Similarly, muscle weakness of the legs can make it difficult for a person to maintain their balance and walk. A recent study on the effects of strength training for children with cerebral palsy concluded that a combination of progressive strength training with task-specific training can reduce muscle weakness. A similar study found that task-specific strength training for children aged 4-8 years with cerebral palsy resulted in improved strength that was maintained over time.
Increases in joint strength
The amount of muscle is directly proportionate to the strength of the muscle. Since people with cerebral palsy have less volume of muscle, they have less strength. Orthoses are often used to provide joint stability but this can have a negative effect in the long run. For instance, researchers found that ankle-foot orthosis can provide stability of the ankle but it can lead to disuse weakness as it restricts the movement of the ankle joint. Strength training which focuses on the hip extensors and flexors, the knee extensors, and the ankle plantar flexors increases the strength of the joints of all the targeted muscles. Other studies have found a correlation between walking speed and walking endurance and lower-limb isometric joint strength.
Improves walking ability
Children with cerebral palsy have about 36% to 82% of the muscle strength of typically developing children. This is associated with muscle weakness in the lower limbs which results in decreased walking capacity. A study on improving walking capacity through resistance training found that resistance training with exercises at high movement velocities provided significant improvements. The children in the study showed an increase of 13% in their walking velocity and walking capacity increases ranged from 13% to 83%. The results of this study indicate that 3 sets of 6 to 8 repetitions at maximal effort, 3 times a week for 14 weeks can help to improve walking and sprinting performance in those with cerebral palsy.
Increases gait function
Spasticity or contractures of muscles cause gait deviations which increases the energy requirement of walking. In fact, children with cerebral palsy expend as much as three times the energy required for walking as compared to their typically developed peers. Multiple studies show positive effects of strength training on gait function in children with cerebral palsy. One study found that strength training 3 times a week for 8 weeks increased muscle strength, stride length and Gross Motor Function Measure (GMFM). The training focused on the lower extremity muscles and used free weights, rubber bands and body weight for resistance.
Provides psychological benefits
Most of the discussion on cerebral palsy focuses on physical disability and not on the psychological impact of this condition. 25% of children with cerebral palsy exhibit behavior problems such as hyperactivity and anxiety and are prone to conflict with their peers. Children with cerebral palsy are also more likely to have a strong emotional response to a new challenge. Similarly, teens and adults with cerebral palsy are at a higher risk for depression and anxiety disorders. Participants in a study on the benefits of strength training for young people with cerebral palsy reported psychological benefits from their 6-week program. This included feelings of increased well-being as well as improved participation in their school and leisure activities.
Strength training offers a variety of health benefits but it is important to keep in mind that each individual is unique and therefore has unique requirements. Researchers point to the fact that children in their study have a range of responses to the training. While some have marked improvement in strength and endurance others have moderate improvement only in strength. This is why it is important to ensure that each individual with cerebral palsy receives the type of treatment that is most effective for him/her. Therapy and counseling can help people living with cerebral palsy stay mentally and emotionally strong through the many challenges they face. Cerebral palsy support groups and forums can also help individuals to connect with others who are in similar situations and can provide practical advice and guidance.