Effectiveness of functional progressive resistance exercise training on walking ability in children with cerebral palsy: A randomized controlled trial Vanessa A. Scholtes a , Jules G. Becher a , Yvonne J. Janssen-Potten b , Hurnet Dekkers c , Linda Smallenbroek d , Annet J. Dallmeijer a, * a Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research and Research Institute MOVE, VU University Medical Center, Amsterdam, The Netherlands b Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands c Rehabilitation Centre Heliomare, Wijk aan Zee, The Netherlands d Reade, Center for Rehabilitation and Rheumatology, Amsterdam, The Netherlands 1. Introduction Children with cerebral palsy (CP) experience various impaired muscle functions, such as reduced selective motor control, spasticity and muscle weakness (Bax et al., 2005). These impairments often lead to difficulty with (certain aspects of) walking, such as walking speed, walking endurance or climbing stairs. Improving walking ability is an important treatment goal of therapeutic interventions for children with CP. There is increasing interest in studying muscle strength management in these children (Dodd, Taylor, & Graham, 2003; Lee, Sung, & Yoo, 2007; Liao, Liu, Liu, & Lin, 2007; Unger, Faure, & Frieg, 2006), since it has been suggested that muscle weakness has a strong association with mobility limitations (Ross & Engsberg, 2007). Progressive Resistance Exercise (PRE) training is a well established strength training method, in which the intensity progresses with time. This stimulates strength gains that are greater than those associated with normal growth and Research in Developmental Disabilities 33 (2012) 181–188 A R T I C L E I N F O Article history: Received 19 July 2011 Received in revised form 29 August 2011 Accepted 29 August 2011 Available online 11 October 2011 Keywords: Cerebral palsy Clinical trial Child Resistance training Walking ability A B S T R A C T The objective of the study was to evaluate the effectiveness of functional progressive resistance exercise (PRE) training on walking ability in children with cerebral palsy (CP). Fifty-one ambulant children with spastic CP (mean age 10 years 5 months, 29 boys) were randomized to an intervention (n = 26) or control group (n = 25, receiving usual care). The intervention consisted of 12 weeks functional PRE circuit training, for 3 times a week. Main outcome measures were walking ability and participation. Secondary outcomes were muscle strength and anaerobic muscle power. Possible adverse outcomes were spasticity and passive range of motion (ROM). Muscle strength increased significantly in the training group compared to the control group, but walking ability, participation and anaerobic muscle power did not change. Spasticity and ROM remained unchanged, except for a significant decrease in rectus femoris length in the intervention group. It is concluded that twelve weeks of functional PRE-training does not improve walking ability, despite improved muscle strength. ß 2011 Elsevier Ltd. All rights reserved. * Corresponding author at: VU University Medical Center, Department of Rehabilitation Medicine, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Tel.: +31 20 444 0469; fax: +31 20 444 7078. E-mail address: a.dallmeijer@vumc.nl (A.J. Dallmeijer). Contents lists available at SciVerse ScienceDirect Research in Developmental Disabilities 0891-4222/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.ridd.2011.08.026