Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Dev Med Child Neurol. 2010 Jun;52(6):e107-13. doi: 10.1111/j.1469-8749.2009.03604.x. Epub 2010 Feb 12.
To evaluate the effectiveness of functional progressive resistance exercise (PRE) strength training on muscle strength and mobility in children with cerebral palsy (CP).
Fifty-one children with spastic uni- and bilateral CP; (29 males, 22 females; mean age 10 y 5 mo, SD 1 y 10 mo, range 6 y 0 mo-13 y 10 mo; Gross Motor Function Classification System levels I-III) were randomized to the intervention group (n=26) or the control group (n=25, receiving usual care). The intervention group trained for 12 weeks, three times a week, on a five-exercise circuit, which included a leg-press and functional exercises. The training load progressively increased based on the child's maximum level of strength, determined by the eight-repetition maximum. Muscle strength (measured with hand-held dynamometry and a six-repetition maximum leg-press test), mobility (measured with the Gross Motor Function Measure, two functional tests, and a mobility questionnaire), and spasticity (measured by the appearance of a catch) were evaluated before, during, directly after, and 6 weeks after the end of training by two blinded research assistants.
Directly after training, there was a statistically significant effect (p<0.05) on muscle strength (knee extensors +12% [0.56 N/kg; 95% confidence interval {CI} 0.13-0.99]; hip abductors +11% [0.27 N/kg; 95% CI 0.00-0.54]; total +8% [1.30 N/kg; 95% CI 0.56-2.54]; six-repetition maximum +14% [14%; 95% CI 1.99-26.35]), but not on mobility or spasticity. A detraining effect was seen after 6 weeks.
Twelve weeks of functional PRE strength training increases muscle strength up to 14%. This strength gain did not lead to improved mobility.
评估功能性渐进抗阻力量训练（PRE）对脑瘫儿童肌肉力量和活动能力的有效性。
51 名痉挛型单侧和双侧脑瘫儿童（男 29 名，女 22 名；平均年龄 10 岁 5 个月，标准差 1 岁 10 个月，范围 6 岁 0 个月-13 岁 10 个月；粗大运动功能分级系统 I-III 级）被随机分为干预组（n=26）或对照组（n=25，接受常规护理）。干预组每周训练 3 次，共 12 周，采用包括腿部按压和功能性运动在内的 5 项运动的循环训练。训练负荷根据儿童的最大力量水平（通过 8 次重复最大力量确定）逐渐增加。肌肉力量（使用手持测力计和 6 次重复最大腿部按压测试测量）、活动能力（使用粗大运动功能测量、2 项功能性测试和活动能力问卷测量）和痉挛程度（通过出现的“捕获”现象测量）在训练前、训练期间、训练结束后直接以及训练结束后 6 周由 2 名盲法研究助理进行评估。
训练结束后直接，肌肉力量有统计学显著效果（p<0.05）（膝关节伸展肌+12%[0.56 N/kg；95%置信区间（CI）0.13-0.99]；髋关节外展肌+11%[0.27 N/kg；95%CI 0.00-0.54]；总肌+8%[1.30 N/kg；95%CI 0.56-2.54]；6 次重复最大量+14%[14%；95%CI 1.99-26.35%]），但活动能力和痉挛程度没有变化。6 周后出现脱训效应。
12 周的功能性 PRE 力量训练可使肌肉力量增加 14%。这种力量的增加并没有导致活动能力的提高。
