Effects of a postoperative resistive exercise program on the knee extension and flexion torque in children with cerebral palsy: a randomized clinical trial

Abstract

Objective: To investigate the effects of resistive exercise on the knee extension and flexion torque production during the rehabilitation period after multilevel orthopedic surgery.

Design: Randomized clinical trial.

Setting: Hospital rehabilitation department.

Participants: Thirty-nine children with spastic diplegic cerebral palsy (CP) (age range, 6-16 y), randomly allocated to an exercise group (n=19) and a control group (n=20). All received conventional physiotherapy (PT), and the exercise group also followed a resistive exercise program.

Intervention: A 9-month standardized home-based resistive exercise program, which started about 3 months after the surgery.

Main outcome measures: The Gross Motor Functional Measurement (GMFM) assessed before (E(0)) and 1 year (E(1)) after the surgery. The Modified Ashworth Scale and the isometric and isokinetic torque of the knee extensors and flexors were evaluated at E(0), E(1), and 6 months after the surgery.

Results: The knee extension and flexion moments had decreased 6 months after the surgery and recovered to the preoperative level 1 year after surgery. These changes were not group dependent.

Conclusions: Additional long-term, home-based, low-cost resistive exercise that starts soon after the operation of patients with CP was not more beneficial than conventional PT only, in terms of strength and GMFM.