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Does home-based progressive resistance or high-intensity circuit training improve strength, function, activity or participation in children with cerebral palsy? [with consumer summary]
Schranz C, Kruse A, Belohlavek T, Steinwender G, Tilp M, Pieber T, Svehlik M
Archives of Physical Medicine and Rehabilitation 2018 Dec;99(12):2457-2464
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Does home-based progressive resistance or high-intensity circuit training improve strength, function, activity, or participation in children with cerebral palsy (CP)? DESIGN: This was the first study on high-intensity circuit training for children with CP. This study was conducted as a randomized prospective controlled pilot study. SETTING: Evaluation took place at the gait laboratory of the university hospital, training sessions were performed at home. PARTICIPANTS: Children (n = 22) with CP (average age 12 y, 10 mo, 19 Gross Motor Function Classification System level I, 3 level II) were randomly assigned either to progressive resistance training (PRT) or high-intensity circuit training (HICT). INTERVENTIONS: The PRT group trained with progressive overload, while the HICT group performed as many repetitions as possible within 30-second intervals (8 wk, 3 times weekly in both groups). MAIN OUTCOME MEASURES: Outcome measures stretched over all domains of the International Classification of Functioning, Disability and Health and included muscle strength, muscle power sprint test (MPST), timed stairs test (TST), 6-minute walking test, Gait Profile Score (GPS), timed Up and Go test (TUGT) and participation questionnaires. RESULTS: Only the HICT group was able to improve strength. Furthermore, the HICT group scored better in the MPST, while PRT participants improved in the TST and TUGT. The HICT-group was able to show improvement in the subscores of the parent-reported participation questionnaire. Other measures of mobility or participation did not change. CONCLUSIONS: Both programs improved function specific to intervention. However, only the HICT group showed significant strength and participation improvements. Compliance was decent in both groups, but the average training unit was shorter in the HICT group. Both exercise programs showed functional benefits, but HICT might be the preferable option for strengthening in highly functional children with CP.

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