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Neuromuscular adaptations to eccentric strength training in children and adolescents with cerebral palsy
Reid S, Hamer P, Alderson J, Lloyd D
Developmental Medicine and Child Neurology 2010 Apr;52(4):358-363
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; 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*

AIM: To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP). METHOD: In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11 y, SD 2 y range 9 to 15 y), diagnosed with upper-limb spasticity were compared with 14 age- and sex-matched typically developing participants. Participants with CP completed a 6-week progressive resistance-strengthening programme, performing eccentric lengthening contractions of their upper limb three times a week. Data from dynamometer and surface electromyography (EMG) assessments included peak torque normalised to body mass (T/Bm), work normalised to body mass (W/Bm), angle at peak torque, curve width, and EMG activation. RESULTS: After training, children with CP had improved eccentric T/Bm (p = 0.009) and W/Bm (p = 0.009) to a level similar to that of the typically developing children. No change in angle of peak torque occurred, although curve width increased both concentrically (p = 0.018) and eccentrically (p = 0.015). EMG activity was elevated before training in children with CP but decreased with training to levels similar to those of the typically developing children. INTERPRETATION: With eccentric strength training, children with CP increased torque throughout range of motion. Results suggest that eccentric exercises may decrease co-contraction, improving net torque development. Eccentric actions may be important in the maintenance of the torque-angle relationship. These results have significant implications for the prescription of strength-training programmes for people with CP.

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