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Meta-Analysis
. 2022 Jan;36(1):4-14.
doi: 10.1177/02692155211040199. Epub 2021 Aug 18.

Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis

Javier Merino-Andrés  1   2   3 , Agustín García de Mateos-López  4 , Diane L Damiano  5 , Alberto Sánchez-Sierra  2   3   6   7
Affiliations
Meta-Analysis

Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis

Javier Merino-Andrés et al. Clin Rehabil. 2022 Jan.

Abstract

Objective: This systematic review and meta-analysis investigates the effects of strength training program in children and adolescents with cerebral palsy to improve function, activity, and participation.

Data sources: Five electronic databases (MEDLINE-Pubmed, Cochrane Library, PEDro, CINAHL, and SPORTDiscus) were systematically searched for full-text articles published from inception to 30 June 2021.

Review methods: Randomized controlled trials were included, who compared: (i) child population with spastic cerebral palsy population between 0 and 22 years; (ii) studies in which a muscle strength training program was performed and included dosing information; (iii) studies comparing strength training with other physical therapy technique(s) or untreated control group. Studies with similar outcomes were pooled by calculating standardized mean differences. Risk of bias was assessed with Cochrane Collaboration's tool for assessing the risk of bias and PROSPERO's registration number ID: CRD42020193535.

Results: Twenty-seven studies, comprising 847 participants with spastic cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of strength training program compared to other physical therapy technique(s) or untreated control group(s) for muscle strength at the knee flexors, at the knee extensor, at the plantarflexors, maximum resistance, balance, gait speed, GMFM (global, D and E dimension) and spasticity.

Conclusion: A strength training program has positive functional and activity effects on muscle strength, balance, gait speed, or gross motor function without increasing spasticity for children and adolescents with cerebral palsy in Gross Motor Function Classification System levels I, II, and III when adequate dosage and specific principles are utilized.

Keywords: Cerebral palsy; meta-analysis; pediatric; strengthening; systematic review.

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Conflict of interest statement

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of included studies.
Figure 2.
Figure 2.
Forest plots of pooled effect size for GMFM total score improvement.
Figure 3.
Figure 3.
Forest plots of pooled effect size for GMFM dimension D score improvement.
Figure 4.
Figure 4.
Forest plots of pooled effect size for GMFM dimension E score improvement.
See this image and copyright information in PMC

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