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Effects of a postoperative resistive exercise program on the knee extension and flexion torque in children with cerebral palsy: a randomized clinical trial
Patikas D, Wolf SI, Armbrust P, Mund K, Schuster W, Dreher T, Doderlein L
Archives of Physical Medicine and Rehabilitation 2006 Sep;87(9):1161-1169
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; 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: To investigate the effects of resistive exercise on the knee extension and flexion torque production during the rehabilitation period after multilevel orthopedic surgery. DESIGN: Randomized clinical trial. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty-nine children with spastic diplegic cerebral palsy (CP) (age range 6 to 16 y), randomly allocated to an exercise group (n = 19) and a control group (n = 20). All received conventional physiotherapy (PT), and the exercise group also followed a resistive exercise program. INTERVENTION: A 9-month standardized home-based resistive exercise program, which started about 3 months after the surgery. MAIN OUTCOME MEASURES: The Gross Motor Functional Measurement (GMFM) assessed before (E0) and 1 year (E1) after the surgery. The Modified Ashworth Scale and the isometric and isokinetic torque of the knee extensors and flexors were evaluated at E0, E1, and 6 months after the surgery. RESULTS: The knee extension and flexion moments had decreased 6 months after the surgery and recovered to the preoperative level 1 year after surgery. These changes were not group dependent. CONCLUSIONS: Additional long-term, home-based, low-cost resistive exercise that starts soon after the operation of patients with CP was not more beneficial than conventional PT only, in terms of strength and GMFM.

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