Isokinetic Strength Training in Children With Hemiparetic Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      This study endeavored to assess the effect of an isokinetic strength training (IsoK-ST)
      program on weight-bearing symmetry, gait-symmetry, and dynamic balance in children with
      hemiparetic cerebral palsy (HCP). Thirty-six children with HCP were randomly allocated to the
      IsoK-ST group (n = 18, received their usual physical rehabilitation program plus an IsoK-ST
      program) or the Control group (n =18, received usual physical rehabilitation alone). Both
      groups were assessed for weight-bearing symmetry, gait-symmetry, and dynamic balance before
      and after treatment.
    

Detailed description: 
      Thirty-six children with HCP were recruited from the Physical Therapy Outpatient Clinic of
      Collee of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, King Khalid
      Hospital, and a tertiary referral hospital, Al-Kharj, Saudi Arabia. Their age ranged between
      8 and 16 years, were functioning at levels I or II according to the Gross Motor Function
      Classification System, and had spasticity level 1 or 1+ per the Modified Ashworth Scale.
      Children were excluded if they had structural nonreducible deformities, underwent
      neuromuscular or orthopedic surgery in the last 12 months, submitted to BOTOX injection in
      the past 6 months, sensory-perceptual disorders, unstable convulsions, cardiopulmonary
      problems preventing them from performing high-intense exercise training.

      Outcome measures

        1. Weight-bearing symmetry index: The weight-bearing symmetry index for the rearfoot and
           forefoot segments were assessed through a pressure analysis system

        2. Gait-symmetry Indices: Gait symmetry indices (Spatial and temporal) were measured
           through the portable GAIT Rite system.

        3. Dynamic balance: The directional dynamic limit of stability (forward, backward, paretic,
           and non-paretic) and overall limit of stability were assessed using the Biodex balance
           system.

      The IsoK-ST and control groups received their usual physical rehabilitation program for 45
      minutes, three times a week for eight consecutive weeks. The program comprised advanced
      balance training, and gait training exercises, postural and flexibility exercises, strength
      training exercises. Additionally, the IsoK-ST group received an IsoK-ST program, thrice/week
      for eight weeks per the National Strength and Conditioning Association guidelines and
      American Academy of Pediatrics safety standards. The IsoK-ST consisted of 3 sets (5-10
      repetitions) of maximal concentric contraction of knee extensors and flexors on the affected
      side at angular speeds of 90, 120, 180, and 240 deg./sec., with intervals of rest for two
      minutes after each selected speed. The IsoK-ST workout was proceeded by a 5-minute warm-up
      and ended up with a 5-minute cool-dowm.
    

Intervention name(s): Physical Therapy
Intervention type(s): Other
Intervention description(s): The IsoK-ST group received their usual physical therapy program for 45 minutes, three times a week for eight successive weeks, which comprised advanced balance training, weight-bearing exercises, gait training, postural and flexibility exercises, and strength training exercises.
Additionally, the IsoK-ST group received an IsoK-ST program, thrice/week for eight successive weeks.
The control group received the usual physical rehabilitation program only for 45 minutes, three times a week for eight successive weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective pre-test post-test randomized controlled trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment