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What are the optimum training parameters of progressive resistance exercise for changes in muscle function, activity and participation in people with cerebral palsy? A systematic review and meta-regression [with consumer summary]
Bania TA, Taylor NF, Chiu HC, Charitaki G
Physiotherapy 2022 Jun;119:1-16
systematic review

OBJECTIVES: To explore the effect of progressive resistance exercise (PRE) on impairment, activity and participation of people with cerebral palsy (CP). Also, to determine which programme parameters provide the most beneficial effects. DATA SOURCES: Electronic databases searched from the earliest available time. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) implementing PRE as an intervention in people with cerebral palsy were included. STUDIES APPRAISAL AND SYNTHESIS METHODS: Methodological quality of trials was assessed with the PEDro scale. Meta-analysis and meta-regression were completed. RESULTS: We included 20 reports of 16 RCTs (n = 504 participants). Results demonstrated low certainty evidence that PRE improved muscle strength (pooled standardised mean difference (SMD) 0.59 (95% CI 0.16 to 1.01; I2 70%). This increase in muscle strength was maintained an average of 11 weeks after training stopped. Tauhere was also moderate certainty evidence that it is inconclusive whether PRE has a small effect on gross motor function (SMD 0.14 (95% CI -0.09 to 0.36; I2 0%) or participation (SMD 0.26 (95% CI -0.02 to 0.54; I2 0%). When PRE was compared with other therapy there were no between-group differences. Meta-regression demonstrated no effect of PRE intensity or training volume (frequency x total duration) on muscle strength (p > 0.5). No serious adverse events were reported. There is lack of evidence of the effectiveness of PRE in adults and non-ambulatory people with CP. CONCLUSIONS: PRE is safe and increases muscle strength in young people with CP, which is maintained after training stops. The increase in muscle strength is unrelated to the PRE intensity or dose.

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