OBJECTIVE: To investigate effectiveness of a functional strengthening program, the loaded sit-to-stand (STS) resistance exercise, for children with cerebral palsy (CP). DESIGN: A single-blind, randomized block design. SETTING: STS exercises were carried out at the children's homes. PARTICIPANTS: Twenty children (12 boys, 8 girls; age range 5 to 12 y) with spastic diplegia CP and classified by the Gross Motor Function Classification System as level I or II were stratified by their severity and age and randomly allocated into either the experimental or control group. INTERVENTION: Both groups received their regular physical therapy. The experimental group underwent loaded STS exercise 3 times a week for 6 weeks. MAIN OUTCOME MEASURES: Goal dimension scores of the Gross Motor Function Measure (GMFM), gait speed, 1 repetition maximum (1-RM) of the loaded STS, isometric strength of knee extensor, and Physiological Cost Index (PCI). The outcome measures were conducted at the beginning and end of the 6-week study. RESULTS: After loaded STS exercise, the experimental group showed statistically significant differences in GMFM goal dimension scores, 1-RM STS, and PCI from the control group. The changes in gait speed and isometric strength of the knee extensor did not differ significantly between the 2 groups. CONCLUSIONS: After the loaded STS exercise, children with mild spastic diplegia improved their basic motor abilities, functional muscle strength, and walking efficiency.

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