Morton Jan F, Brownlee Margaret, McFadyen Angus K
Yorkhill NHS Trust, Glasgow, UK.
Clin Rehabil. 2005 May;19(3):283-9. doi: 10.1191/0269215505cr804oa.
To investigate the effects of progressive resistance training of quadriceps and hamstrings muscles in children with cerebral palsy (CP).
Pilot study using a repeated measures design with measurements at baseline, immediately after six weeks training then at four-week follow-up.
The project was undertaken within the physiotherapy department of two special schools in Glasgow.
A convenience sample of eight children aged between six and 12 years, with hypertonic CP.
The subjects participated three times per week in a six-week, progressive, free-weight, strengthening programme.
Maximum isometric muscle strength and resistance to passive stretch were measured with a hand-held myometer. The Gross Motor Function Measure and a 10-metre timed walking test, were used to assess function and gait parameters respectively.
Muscle strength increased, with the quadriceps to hamstrings strength ratio moving towards normal. These changes were retained at follow-up. Muscle tone decreased and continued to decrease to follow-up. The standing (D) and walking, running and jumping (E) goal areas of the Gross Motor Function Measure showed improvement that continued towards follow-up. Walking speed and step rate increased.
A future large-scale randomized controlled study would be of value to substantiate these results as the small convenience sample and lack of control group limit this study. However, the finding that no adverse effect accompanied the positive outcomes in strength and function may encourage clinicians to consider resistance training alongside standard therapeutic interventions.
研究对脑瘫（CP）患儿进行股四头肌和腘绳肌渐进性抗阻训练的效果。
采用重复测量设计的试点研究，在基线、六周训练结束后立即以及四周随访时进行测量。
该项目在格拉斯哥两所特殊学校的理疗科开展。
选取8名年龄在6至12岁之间、患有张力亢进型脑瘫的儿童作为便利样本。
受试者每周参加三次为期六周的渐进式自由重量强化训练计划。
使用手持肌力计测量最大等长肌力和被动拉伸阻力。分别采用粗大运动功能测量量表和10米定时步行测试来评估功能和步态参数。
肌肉力量增强，股四头肌与腘绳肌力量比趋向正常。这些变化在随访时得以保持。肌张力降低，且在随访期间持续下降。粗大运动功能测量量表的站立（D）以及行走、跑步和跳跃（E）目标区域显示出改善，并持续至随访阶段。步行速度和步频增加。
鉴于本研究样本量小且缺乏对照组，未来开展大规模随机对照研究对于证实这些结果具有重要价值。然而，在力量和功能方面取得积极结果且未出现不良反应这一发现，可能会促使临床医生在标准治疗干预的同时考虑抗阻训练。
