Valadão Pedro, Cenni Francesco, Piitulainen Harri, Avela Janne, Finni Taija
Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND.
Med Sci Sports Exerc. 2024 Jan 1;56(1):1-12. doi: 10.1249/MSS.0000000000003273. Epub 2023 Aug 7.
Numerous exercise interventions to enhance motor function in cerebral palsy (CP) have been proposed, with varying degrees of effectiveness. Because motor function requires a combination of muscle strength, joint flexibility, and motor coordination, we designed a supervised multicomponent exercise intervention (EXErcise for Cerebral Palsy, or EXECP) for individuals with CP. Our aim was to evaluate the effects of the EXECP intervention and its retention after it ceased.
The EXECP intervention combined strength training for the lower limbs and trunk muscles, passive stretching for the lower limb muscles, and inclined treadmill gait training. Eighteen participants with CP (mean age, 14 yr; 13 were male) were tested twice before the 3-month intervention and twice after the intervention, each test separated by 3 months. Seventeen typically developing age- and sex-matched controls were tested twice. Motor function was assessed with the 6-min walking test (6MWT) and the gross motor function measure dimensions D and E. Passive joint flexibility was measured with goniometry. Isometric and concentric muscle strength were assessed at the knee, ankle, and trunk joints.
The EXECP intervention successfully increased 6MWT ( P < 0.001), gross motor function measure ( P = 0.004), and muscle strength for knee and trunk muscles ( P < 0.05), although no changes were observed for ankle joint muscles. Hip and knee joint flexibility also increased ( P < 0.05). After the retention period, all tested variables except the 6MWT and knee joint flexibility regressed and were not different from the pretests.
The improvements in strength, flexibility, and possibly motor coordination brought by the EXECP intervention were transferred to significant functional gains. The regression toward baseline after the intervention highlights that training must be a lifelong decision for individuals with CP.
已提出多种运动干预措施来增强脑瘫（CP）患者的运动功能，但其有效性程度各异。由于运动功能需要肌肉力量、关节灵活性和运动协调性相结合，我们为CP患者设计了一种有监督的多成分运动干预方案（脑瘫运动训练，即EXECP）。我们的目的是评估EXECP干预的效果及其停止后的维持情况。
EXECP干预结合了下肢和躯干肌肉的力量训练、下肢肌肉的被动拉伸以及倾斜跑步机步态训练。18名CP患者（平均年龄14岁；13名男性）在3个月干预前测试两次，干预后测试两次，每次测试间隔3个月。17名年龄和性别匹配的典型发育对照者测试两次。通过6分钟步行测试（6MWT）和粗大运动功能测量维度D和E评估运动功能。用测角法测量被动关节灵活性。在膝关节、踝关节和躯干关节评估等长和向心肌肉力量。
EXECP干预成功提高了6MWT（P<0.001）、粗大运动功能测量值（P =
