Strengthening: Research on Resistance Training and Therapist Resources

This article looks at the effectiveness of resistance training for those children with cerebral palsy (CP). However, the article also summarizes the strength training protocols for typically developing children and is applicable to children that don’t have CP.

Currently, there is not many adequate randomized controlled trails done that prove the effectiveness of resistance training for children with CP. This does not, however, negate the possible positive effects that strength training can have in therapy. Due to the nature of CP, it is reasonable to infer that strength training is one way to strengthen the weak muscles for those individuals with CP. 

This study’s recommendations are based on the guidelines established by the National Strength and Conditioning Association (NSCA). The authors state that there is no reason as to why guidelines used for typically developing children in regard to strength training can’t apply to children with CP, and state that “the duration of the training should be sufficiently long and the intensity high enough to maximize the possibility of both neural adaptation and muscle hypertrophy and that the participants should be old enough to fully participate and give maximum voluntary effort during training.”¹

Recommendations

For individuals with CP, it is recommended to focus on single-joint exercises because “alterations in task performance may occur to compensate for very weak muscles.”² More complex exercises can be added to the therapy regimen later.

Exercises should be done 2 to 3 times a week for at least 12 weeks. Warm-up procedures can be an important part of therapy as they are “designed to elevate core body temperature, enhance motor unit excitability, improve kinesthetic awareness, and maximize active range of motion.”³ Also, proper rest should be given to children between repetitions of exercises, perhaps even up to 2 to 3 minutes.

Children can typically start strength training at around the age of 7, or when they are capable of following directions and perform the exercises properly. Form and technique are important.  

Exercise Ideas and Resources

Here is a fact sheet about strength testing and the different muscle testing methods. 

This article by the Fusion Web Clinic gives great exercises for pediatric core strengthening, improving gross motor skills, and gaining mobility. 

ChoosePT also lists more great ideas of activities to promote development.

• In-Text Citations

  1. Verschuren, Olaf, et al., “Muscle Strengthening in Children and Adolescents with Spastic Cerebral Palsy: Considerations for Future Resistance Training Protocols,” Physical Therapy. Volume 91, Issue 7 (2011): 1132, https://doi.org/10.2522/ptj.20100356.

  2. Verschuren et al., “Muscle Strengthening,” 1134.

  3. Ibid, 1135.

• Source

  Verschuren, Olaf, et al., “Muscle Strengthening in Children and Adolescents with Spastic Cerebral Palsy: Considerations for Future Resistance Training Protocols,” Physical Therapy. Volume 91, Issue 7 (2011): Pages 1130–1139, https://doi.org/10.2522/ptj.20100356.