AIM: To evaluate the effectiveness of functional progressive resistance exercise (PRE) strength training on muscle strength and mobility in children with cerebral palsy (CP). METHOD: Fifty-one children with spastic uni- and bilateral CP; (29 males, 22 females; mean age 10 y 5 mo, SD 1 y 10 mo, range 6 y 0 mo to 13 y 10 mo; Gross Motor Function Classification System levels I to III) were randomized to the intervention group (n = 26) or the control group (n = 25, receiving usual care). The intervention group trained for 12 weeks, three times a week, on a five-exercise circuit, which included a leg-press and functional exercises. The training load progressively increased based on the child's maximum level of strength, determined by the eight-repetition maximum. Muscle strength (measured with hand-held dynamometry and a six-repetition maximum leg-press test), mobility (measured with the Gross Motor Function Measure, two functional tests, and a mobility questionnaire), and spasticity (measured by the appearance of a catch) were evaluated before, during, directly after, and 6 weeks after the end of training by two blinded research assistants. RESULTS: Directly after training, there was a statistically significant effect (p < 0.05) on muscle strength (knee extensors +12% (0.56 N/kg; 95% confidence interval (CI) 0.13 to 0.99); hip abductors +11% (0.27 N/kg; 95% CI 0.00 to 0.54); total +8% (1.30 N/kg; 95% CI 0.56 to 2.54); six-repetition maximum +14% (14%; 95% CI 1.99 to 26.35)), but not on mobility or spasticity. A detraining effect was seen after 6 weeks. INTERPRETATION: Twelve weeks of functional PRE strength training increases muscle strength up to 14%. This strength gain did not lead to improved mobility.

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