Effects of a postoperative resistive exercise program on the knee extension and flexion torque in children with cerebral palsy: a randomized clinical trial.

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, 6-16 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 (E(0)) and 1 year (E(1)) after the surgery. The Modified Ashworth Scale and the isometric and isokinetic torque of the knee extensors and flexors were evaluated at E(0), E(1), 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.