Effectiveness of resistance training exercises in spastic diplegia cerebral palsy: a review

Cerebral Palsy presents itself in a clinical form of spastic diplegia, where neurological sequels are predominant in the lower limbs and substantially affects the capacity to walk. Traditional methods of physiotherapy intervention emphasize the techniques of neurological rehabilitation at the expense of progressive resistance exercises.The goal of the present research is to fulfill a bibliographic review concerning the period of 1985 to 2012 about studies that investigated the effect of resistance exercises applied to cerebral palsy children carrying spastics’ diplegia. The Scielo, MEDLINE, PubMed, EMBASE, CINAHL, Sports Discus, DARE, PsychInfo, ERIC, Ausport-Med, AMI, Cochrane and PEDro databases were used to conduct a literature search using keywords without restrictions. In this systematization, a search was conducted using the keywords: cerebral palsy, progressive resistance exercise, diplegia, gross motor function measure (GMFM). Literature have shown that the restrict capacity to generate force is as debilitating or more than it is the muscle spasticity, potentially causing more restriction to the movement than the spasticity itself. Children with normal motor development, as well as carrying spastic diplegia increase their capacity to generate strength when submitted to a resistive training, not only on lower limbs, but also on upper limbs. Furthermore, several studies have shown that diplegic cerebral palsy children improve their motor ability due to strength training, thought it still remains to be proved that strength training leads to a substantial change for the better allowing that there is ascension of category for functional capacity.

Estudo de transferência e locomoção em crianças de 4 a 6 anos com paralisia diparética espástica nível motor III / Study about transfer and locomotion in 4 to 6 years-old children with motor level III spastic diplegig cerebral palsy

Este estudo objetivou traçar o perfil funcional de crianças com paralisia cerebral diparética espástica nível motor III, quanto ao desempenho de atividades de mobilidade – transferência e locomoção –, a fim de direcionar estratégias terapêuticas de avaliação e de intervenção nesta população. O estudo teve a participação de oito crianças que frequentavam o Setor de Fisioterapia Infantil da Associação de Assistência à Criança Deficiente (AACD). As crianças foram avaliadas pelo teste funcional PEDI, sendo utilizada apenas a escala de mobilidade das três partes que o compõem, que teve como referencial de comparação o GMFM. Os resultados demonstraram maior dificuldade dessas crianças nas atividades de locomoção, comparadas com as de transferência. Há necessidade de adequar a assistência do cuidador e as modificações do ambiente para promover maior independência e funcionalidade às crianças.(AU)

Establishing the functional profile of children with motor level III spastic diplegic cerebral palsy, regarding the performance of mobility activities – transfer and locomotion – in order to direct therapeutic strategies for evaluating and intervening in this population was the goal of this study. Eight children who attended the Children’s Physical Therapy Department of the Associação de Assistência à Criança Deficiente (AACD) took part in this study. These children were evaluated by the functional test PEDI – only the mobility scale of the three parts that compose the test was used, and had the GMFM as a comparison reference. The results have showed that children have greater difficulty in locomotion compared to transfer. There is the need to adequate caretaker assistance and to adapt the environment to promote higher independency and functionality to the children.(AU)

Estudo de transferência e locomoção em crianças de 4 a 6 anos com paralisia diparética espástica nível motor III / Study about transfer and locomotion in 4 to 6 years-old children with motor level III spastic diplegig cerebral palsy

Este estudo objetivou traçar o perfil funcional de crianças com paralisia cerebral diparética espástica nível motor III, quanto ao desempenho de atividades de mobilidade – transferência e locomoção –, a fim de direcionar estratégias terapêuticas de avaliação e de intervenção nesta população. O estudo teve a participação de oito crianças que frequentavam o Setor de Fisioterapia Infantil da Associação de Assistência à Criança Deficiente (AACD). As crianças foram avaliadas pelo teste funcional PEDI, sendo utilizada apenas a escala de mobilidade das três partes que o compõem, que teve como referencial de comparação o GMFM. Os resultados demonstraram maior dificuldade dessas crianças nas atividades de locomoção, comparadas com as de transferência. Há necessidade de adequar a assistência do cuidador e as modificações do ambiente para promover maior independência e funcionalidade às crianças.

Establishing the functional profile of children with motor level III spastic diplegic cerebral palsy, regarding the performance of mobility activities – transfer and locomotion – in order to direct therapeutic strategies for evaluating and intervening in this population was the goal of this study. Eight children who attended the Children’s Physical Therapy Department of the Associação de Assistência à Criança Deficiente (AACD) took part in this study. These children were evaluated by the functional test PEDI – only the mobility scale of the three parts that compose the test was used, and had the GMFM as a comparison reference. The results have showed that children have greater difficulty in locomotion compared to transfer. There is the need to adequate caretaker assistance and to adapt the environment to promote higher independency and functionality to the children.