Improvements in Muscle Strength Are Associated with Improvements in Walking Capacity in Young Children with Cerebral Palsy: A Secondary Analysis

Abstract

Purpose: To evaluate whether changes in lower-limb muscle strength explain changes in walking capacity during 14-week periods of usual care, power training and follow-up for children with spastic cerebral palsy. Methods: Secondary analysis of a previously conducted double-baseline controlled trial of 22 children with spastic cerebral palsy. Generalized estimating equations were used to evaluate the relationships between within-subject changes in isometric muscle strength and walking capacity over 3 periods. Results: Changes in hip abductor strength were associated with changes in the Muscle Power Sprint Test, changes in gastrocnemius and hip abductor strength were associated with changes in the Shuttle Run Test, and changes in gastrocnemius strength were associated with changes in the 1-minute walk test. All associations supported better walking capacity with increased strength. Conclusion: Walking capacity, especially sprint capacity, can be improved by increasing strength by functional power training in this population.