# Exercise as it relates to Disease/Strength Training and Cerebral Palsy
## Strength Training and Cerebral Palsy
### Background

Cerebral Palsy (CP) is a life-long disability impairing the person's movement and posture. It is carried throughout their lifetime, but it does not worsen. The cause has been lead back to damage of the developing brain during pregnancy or shortly after birth. Due to the lack of knowledge on the exact effected area of the brain, there is unfortunately no cure for CP. Every person is affected differently, with different extremes of the disorder. CP can affect body movement through muscle control, muscle coordination, muscle tone, reflexes, posture, and balance. Many people who are affected by CP may also experience visual, learning, hearing, speech, and intellectual difficulties. In some cases they may have epilepsy.

#### Prevalence

Cerebral palsy is the most common childhood physical disability, with every 1 in 500 babies being diagnosed in Australia. In 2014, 34,000 people around Australia were living with cerebral palsy, adding to the 17 million people worldwide. Every 1 in 3 children diagnosed after birth will be unable to walk.

### Benefits of Strength Training with Cerebral Palsy

Muscular Strength is a fundamental aspect of movement, many of those with CP struggle with muscle control and coordination. Studies have shown that strength training in a clinical and in a home-based environment can help improve strength and also improve physical activity in those with CP. Through strength training programs usually for a duration of six to ten weeks, benefits in muscle strength, walking velocity, and gross motor function in relation to standing and walking when the exercises were focused on lower extremities. The exercises conducted were specifically prescribed in order to target the hip extensor, knee extensor, and ankle plantarflexor muscle groups. The exercises used were bilateral heel raises at a height on 20 centimeters, bilateral half squats where the knees flex to between 30 and 60 degrees, and step-ups. Through a simple six-week home-based strength training program, there were improvements in the subjects ankle plantarflexor and knee extensor strength and continued to improve when continued for eighteen weeks. Although there was not a significant increase in the speed that the subjects put through the six-week program could walk, run, or jump, their speed at which they completed the set task increased. Home-based strengthening programs are cost effective and are able to be monitored by the subjects parent. It does not need to be monitored by a healthcare professional or done in a clinical setting. A test as simple as the 3-minute walk test can not only assess lower body strength but also, gait velocity, cadence, step length, energy expended, and distance covered. The 3-minute walk test can be a great test that will allow the subjects medical practitioner to see any improvements in their gait and also their lower body strength after a strength program and can be a great assessment tool.

### Recommendations

Strength training either at home or in a clinical setting is very beneficial for those at any age with CP. The exercises don't have to be overly complicated, simple exercises that target main contributors of lower body movement that are lacking in strength can gradually become stronger over a six-week program, and even stronger over ten to eighteen-weeks of the same training.

### Further reading

* Cerebral Palsy Alliance
* Strength Training in Young People with Cerebral Palsy
* Adults with Cerebral Palsy: Walking Ability After Progressive Strength Training

#### About the Author

* By: Claire Caldicott
* Student number: u3097167
* Class and Unit Number: Health, Disease and Exercise - 8340
* Submitted on: 30/09/14 at 10:00pm

#### References

* 1 2 3 4 5 Cerebral Palsy Alliance 2014, What is Cerebral Palsy https://www.cerebralpalsy.org.au/what-is-cerebral-palsy/ (Accessed 28/09/14)
* ↑ Cerebral Palsy Alliance 2014, Facts about Cerebral Palsy https://www.cerebralpalsy.org.au/what-is-cerebral-palsy/facts-about-cerebral-palsy/ (Accessed 28/09/14)
* 1 2 Dodd, K.J. et al, Graham, H.K. et al, Taylor, N.F. et al (2007) 'A randomized clinical trial of strength training in young people with cerebral palsy'. Developmental Medicine & Child Neurology, Volume 45, Issue 10. pp 652-657. http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2003.tb00866.x/pdf (Accessed 28/09/14)
* ↑ Andersson, C. et al, Grooten, W. et al, Hellsten, M. et al, Kaping, K. et al, Mattsson, E. et al, (2003) 'Adults with cerebral palsy: walking ability after progressive strength training'. Developmental Medicine & Child Neurology. pp 220-228 http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2003.tb00335.x/pdf (Accessed 27/09/14)
* 1 2 3 Dodd, K.J. et al, Graham, H.K. et al, Taylor, N.F. et al (2007) 'A randomized clinical trial of strength training in young people with cerebral palsy'. Developmental Medicine & Child Neurology, Volume 45, Issue 10. pp 652-657. http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2003.tb00866.x/pdf (Accessed 30/09/14)
* 1 2 Eagleton, M. et al, Evans, C.L. et al, Iams, A. et al, McDowell, J. et al, Morrison, R. et al. (2004) 'The Effects of Strength Training on Gait in Adolescents with Cerebral Palsy', American Physical Therapy Association, http://journals.lww.com/pedpt/Abstract/2004/01610/The_Effects_of_Strength_Training_on_Gait_in.5.aspx (Accessed 30/09/14)