ISPUB.COM The Internet Journal of Pediatrics and Neonatology Volume 9 Number 1 1 of 5 The Use of Resistance Training as an Intervention for the Treatment of Gait Dysfunction in Children with Spastic Cerebral Palsy D Lehman, A Garban, L Scott, C Tant, D White Citation D Lehman, A Garban, L Scott, C Tant, D White. The Use of Resistance Training as an Intervention for the Treatment of Gait Dysfunction in Children with Spastic Cerebral Palsy. The Internet Journal of Pediatrics and Neonatology. 2007 Volume 9 Number 1. Abstract The purpose of our literature review was to analyze the strength of research evidence using the Sackett Classification Method, in an effort to identify science related to resistance training and improvement of gait dysfunction in children with spastic cerebral palsy (CP). A literature search of EBSCO host was conducted and articles were chosen from peer-reviewed journals, written in the English language, dating from 1991-2006. Nineteen articles were critically reviewed. The articles addressed resistance training interventions, gait assessments, intra-limb coordination, muscle evaluation, physical therapists' perceptions, and physical therapy interventions. None of the articles reviewed suggested a negative effect from resistance training intervention in the treatment of cerebral palsy, and the evidence justifies the use of strength training for the improvement of gait in this population. INTRODUCTION Two children out of every one-thousand live births in the United States are diagnosed with cerebral palsy (CP), making this the most common cause of physical disability in children. CP is a non-progressive disorder that is acquired prenatally, perinatally, or postnatally resulting in motor, cognitive, sensory, endocrine, or urogenital impairments. The exact cause of CP is unknown; however, prenatal asphyxia and infection are factors that may be involved 1 . There are many types of CP, with spastic CP being the most prevalent, characterized by abnormal patterns of posture and movement with increased tonicity throughout the limbs. With increased limb tonicity, functional tasks such as activities of daily living, transferring, bed mobility, and ambulation are difficult. As a result, individuals with spastic CP and their families depend on rehabilitation teams to address their functional limitations, and to provide assistance when working toward their optimal level of function. Physical therapy intervention specifically focuses on improving the child's functional independence, most typically as it relates to ambulation. Walking abilities may be altered secondary to deficits in balance, endurance, range of motion, coordination, and/or strength 1 . Current literature indicates that lower extremity (LE) weakness is a primary impairment associated with gait deviations in children with spastic CP 2 , 3 , 4 . During this literature search, the authors of this paper discovered a distinct controversy regarding strengthening and spasticity. Dr. Karel Bobath and Dr. Berta Bobath developed a theory in the 1940's suggesting that strengthening a spastic muscle would increase the contraction, thus increasing the spasticity 5 . Ross and Engsberg, on the other hand, discovered that there was no correlation between strength and spasticity 6 . To resolve the controversy related to resistance training and its relationship to the improvement of gait in children with spastic CP, and to synthesize a clear clinical decision to support future evidence-based practice, the authors of this paper chose to delve into a review of recent published research. METHODS The fundamental question of this review is, “Should resistance training be used as an intervention for the treatment of gait dysfunction in children with spastic cerebral palsy?” To determine the answer to this question using evidence-based practice, the authors of this paper began the search using EBSCO host. EBSCO host was accessed through Tennessee State University's library