Task-oriented arm strength training in children with cerebral palsy. A randomized controlled trial protocol and exercise program for functional strength training based on progressive resistance exercise principles
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Abstract
Objective: To compare the effectiveness of Task-Oriented Arm Strength training in children with Cerebral Palsy (TOAST-CP), using Progressive Resistance Exercise principles with manual skill learning in improving the performance of manual daily activities in children with spastic Cerebral Palsy.
Methods/Design: This multicenter randomized controlled trial investigates the effectiveness of TOAST-CP in children with spastic Cerebral Palsy, involving 50 participants aged 8-18 years. Participants are recruited from rehabilitation centers. Eligible participants are randomly allocated to either TOAST-CP or usual care related to manual skill learning.
Intervention: The participants of the intervention group performed a TOAST-CP program, based on individual goals and guided by a progressive resistance exercise algorithm. The control group receives the usual care related to the manual skill learning program. TOAST-CP consists of an individual-based 30-minute session, three times a week over 16 weeks. A specific exercise program is developed.
Outcome: Outcome is measured at baseline at eight weeks, 16 weeks (end of training), three, and six months after training.
As a primary outcome, the Assisting Hand Assessment is used. Secondary outcomes are task-oriented strength measures and muscle strength measures of the upper limb. The Observation and Scoring of Arm Hand Skills (performance and amount of use of both hands), the ABILHAND (-Kids), and the Jebsen Taylor Hand Function test (speed of hand use) are measured. The most important needs and goals for the child and his/her parents are scored by Canadian Occupational Performance Measure and Goal Attainment Scaling.
Article Details
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References
2. Smits-Engelsman BC, Rameckers EA, Duysens J. Muscle force generation and force control of finger movements in children with spastic hemiplegia during isometric tasks. Dev Med Child Neurol. May 2005;47(5):337-42.
3. Damiano DL, Laws E, Carmines DV, Abel MF. Relationship of spasticity to knee angular velocity and motion during gait in cerebral palsy. Gait Posture. Jan 2006;23(1):1-8.
4. KJFM D, EAA R, RJEM S, et al. - Upper Extremity Muscle Strength in Children With Unilateral Spastic Cerebral. - Phys Ther 2020 Dec 7;100(12):2205-2216 doi: 101093/ptj/pzaa155. (- 1538-6724 (Electronic)):- 2205-2216.
5. K K, Id O, S M, et al. - Time Course of Upper Limb Function in Children with Unilateral Cerebral Palsy: A. D - 100883417. (- 1687-5443 (Electronic)):- 2831342.
6. Scholtes VA, Becher JG, Comuth A, Dekkers H, Van Dijk L, Dallmeijer AJ. Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol. Jun 2010;52(6):e107-13. doi:DMCN3604 [pii] 10.1111/j.1469-749.2009.03604.x [doi]
7. JW K, A F, J L, et al. - Progressive resistance training for children with cerebral palsy: A randomized- The Effect of Functional Home-Based Strength Training Programs on the. - Phys Ther 2021 Aug 1;101(8):pzab112 doi: 101093/ptj/pzab112.
8. Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther. Nov 2005;85(11):1208-23.
9. Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Phys Ther. Nov 2006;86(11): 1534-40.
10. Elvrum AK, Braendvik SM, Saether R, Lamvik T, Vereijken B, Roeleveld K. Effectiveness of resistance training in combination with botulinum toxin-A on hand and arm use in children with cerebral palsy: a pre-post intervention study. BMC Pediatr. 2012;12:91. doi:1471-2431-12-91 [pii]10.1186/1471-2431-12-91 [doi]
11. OK K, Id O, C G, et al. - The effects of power exercises on body structure and function, activity and. - Disabil Rehabil 2023 Nov;45(22) :3705-3718 doi: 101080/0963828820222138575. (- 1464-5165 (Electronic)):- 3705-3718.
12. J M-A, Id O, A GdM-L, Id O, DL D, A S-S. - Effect of muscle strength training in children and adolescents with spastic. D - 8802181. (- 1477-0873 (Electronic)):- 4-14.
13. B H, N P, N DB, et al. - Progressive resistance training for children with cerebral palsy: A randomized. D - 101549006. (- 1664-042X (Print)):- 911162.
14. Faigenbaum AD, Myer GD. Pediatric resistance training: benefits, concerns, and program design considerations. Curr Sports Med Rep. May-Jun 2010;9(3):161-8. doi:10.1249/JSR.0b013e3181de1214
15. K R, N R, K O, et al. - Effects of Resistance Training on Academic Outcomes in School-Aged Youth: A. D - 8412297. (- 1179-2035 (Electronic)):- 2095-2109.
16. Scholtes VA, Dallmeijer AJ, Rameckers EA, et al. Lower limb strength training in children with cerebral palsy--a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles. BMC Pediatr. 2008;8:41. doi:1471-2431-8-41 [pii] 10.1186/1471-2431-8-41 [doi]
17. TA B, NF T, HC C, G C. - What are the optimum training parameters of progressive resistance exercise for. D - 0401223. (- 1873-1465 (Electronic)):- 1-16.
18. EA R, YJ J-P, IM E, RJ S. - Efficacy of upper limb strengthening in children with Cerebral Palsy: A critical. D - 8709782. (- 1873-3379 (Electronic)):- 87-101.
19. M G, M K, Id- Orcid X, et al. - Defining Functional Therapy in Research Involving Children with Cerebral Palsy: A. - Phys Occup Ther Pediatr 2020;40(2):231-246 doi: 101080/0194263820191664703. (- 1541-3144 (Electronic)):- 231-246.
20. M J, Id O, L S, et al. - Interventions to improve physical function for children and young people with. - Dev Med Child Neurol 2022 May;64(5):536-549 doi: 101111/dmcn15055 Epub 2021. (- 1469-8749 (Electronic)):- 536-549.
21. Lee DR, You JH, Lee NG, Oh JH, Cha YJ. Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST)-induced morphological changes in muscle size and associated motor improvement in a child with cerebral palsy: an experimenter-blind study. NeuroRehabilitation. 2009;24(2):109-17.
22. Reid S, Hamer P, Alderson J, Lloyd D. Neuromuscular adaptations to eccentric strength training in children and adolescents with cerebral palsy. Dev Med Child Neurol. Apr 2010;52(4):358-63. doi:DMCN3409 [pii] 10.1111/j.1469-8749.2009.03409.x [doi]
23. A K, C S, M S, M T. - The Effect of Functional Home-Based Strength Training Programs on the. D - 8909729. (- 1543-2920 (Electronic)):- 67-76.
24. Yue G, Cole KJ. Strength increases from the motor program: comparison of training with maximal voluntary and imagined muscle contractions. J Neurophysiol. May 1992;67 (5):1114-23.
25. Vila-Cha C, Falla D, Farina D. Motor unit behavior during submaximal contractions following six weeks of either endurance or strength training. J Appl Physiol. Nov 2010; 109(5):1455-66. doi:japplphysiol.01213.2009
[pii] 10.1152/japplphysiol.01213.2009 [doi]
26. Smits-Engelsman BC, Klingels K, Feys H. Bimanual force coordination in children with spastic unilateral cerebral palsy. Res Dev Disabil. May 16 2011;doi:S0891-4222(11)00155-7 [pii]10.1016/j.ridd.2011.04.007 [doi]
27. World Health Organisation. International classification of functioning, disability and health: ICF. 2001.
28. Krumlinde-Sundholm L, Holmefur M, Kottorp A, Eliasson AC. The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change. Dev Med Child Neurol. Apr 2007;49(4):259-64.
29. Eliasson AC, van Dijk H, Jannink MJ, et al. Improving the use of hands in daily activities: aspects of the treatment of children with cerebral palsy. Phys Occup Ther Pediatr. Jul Apr Jan 2005;25(3):37-60.
30. M G, E R, M S, et al. - Reproducibility of Task-Oriented Bimanual and Unimanual Strength Measurement in. D - 8109120. (- 1541-3144 (Electronic)):- 420-432.
31. Arnould C, Penta M, Renders A, Thonnard JL. ABILHAND-Kids: a measure of manual ability in children with cerebral palsy. Neurology. Sep 28 2004;63(6):1045-52.
32. M T, Id O, E C, et al. - Examining Reliability and Validity of the Jebsen-Taylor Hand Function Test Among. D - 0401131. (- 1558-688X (Electronic)):- 684-697.
33. Cup EH, Scholte op Reimer WJ, Thijssen MC, van Kuyk-Minis MA. Reliability and validity of the Canadian Occupational Performance Measure in stroke patients. Clin Rehabil. Jul 2003;17(4):402-9.
34. Steenbeek D, Ketelaar M, Lindeman E, Galama K, Gorter JW. Interrater reliability of goal attainment scaling in rehabilitation of children with cerebral palsy. Arch Phys Med Rehabil. Mar 2010;91(3):429-35. doi:S0003-9993(09)00895-8 [pii] 10.1016/j.apmr.2009.10.013 [doi]
35. Bult MK, Verschuren O, Gorter JW, Jongmans MJ, Piskur B, Ketelaar M. Cross-cultural validation and psychometric evaluation of the Dutch language version of the Children's Assessment of Participation and Enjoyment (CAPE) in children with and without physical disabilities. Clin Rehabil. Sep 2010;24(9):843-53. doi:0269215510367545 [pii] 10.1177/0269215510367545 [doi]
36. Epstein MH, Ryser G, Pearson N. Standardization of the behavioral and emotional rating scale: factor structure, reliability, and criterion validity. J Behav Health Serv Res. May 2002;29(2):208-16.
37. K D, Id O, Y J-P, et al. - Reliability of maximum isometric arm, grip and pinch strength measurements in. - Disabil Rehabil 2020 May;42(10):1448-1453 doi: 101080/0963828820181524522. (- 1464-5165 (Electronic)):- 1448-1453.
38. KJFM D, RJEM S, YJM J-P, AM G, LAWM S, EAA R. - Psychometric Evaluation of 2 New Upper Extremity Functional Strength Tests in. - Phys Ther 2019 Aug 1;99(8):1107-1115 doi: 101093/ptj/pzz019.
(- 1538-6724 (Electronic)):- 1107-1115.
39. M G, E R, C B, A G, R S. - Construct Validity of a Task-Oriented Bimanual and Unimanual Strength Measurement. - Phys Ther 2020 Dec 7;100(12):2237-2245 doi: 101093/ptj/pzaa173.
(- 1538-6724 (Electronic)):- 2237-2245.
40. Speth LA, Leffers P, Janssen-Potten YJ, Vles JS. Botulinum toxin A and upper limb functional skills in hemiparetic cerebral palsy: a randomized trial in children receiving intensive therapy. Dev Med Child Neurol. Jul 2005;47(7):468-73.