Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial

Jennifer M. Ryan; Grace Lavelle; Nicola Theis; Marika Noorkoiv; Cherry Kilbride; Thomas Korff; Vasilios Baltzopoulos; Adam Shortland; Wendy Levin

doi:10.1111/dmcn.14601

Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial

Jennifer M. Ryan^*, Grace Lavelle, Nicola Theis, Marika Noorkoiv, Cherry Kilbride, Thomas Korff, Vasilios Baltzopoulos, Adam Shortland, Wendy Levin

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

Aim: To evaluate the effect of progressive resistance training of the ankle plantarflexors on gait efficiency, activity, and participation in adolescents with cerebral palsy (CP). Method: Sixty-four adolescents (10–19y; 27 females, 37 males; Gross Motor Function Classification System [GMFCS] levels I–III) were randomized to 30 sessions of resistance training (10 supervised and 20 unsupervised home sessions) over 10 weeks or usual care. The primary outcome was gait efficiency indicated by net nondimensional oxygen cost (NNcost). Secondary outcomes included physical activity, gross motor function, participation, muscle strength, muscle and tendon size, and muscle and tendon stiffness. Analysis was intention-to-treat. Results: Median attendance at the 10 supervised sessions was 80% (range 40–100%). There was no between-group difference in NNcost at 10 (mean difference: 0.02, 95% confidence interval [CI] –0.07 to 0.11, p=0.696) or 22 weeks (mean difference: –0.08, 95% CI –0.18 to 0.03, p=0.158). There was also no evidence of between-group differences in secondary outcomes at 10 or 22 weeks. There were 123 adverse events reported by 27 participants in the resistance training group. Interpretation: We found that 10 supervised sessions and 20 home sessions of progressive resistance training of the ankle plantarflexors did not improve gait efficiency, muscle strength, activity, participation, or any biomechanical outcome among adolescents with CP. What this paper adds: Thirty sessions of progressive resistance training of the ankle plantarflexors over 10 weeks did not improve gait efficiency among ambulatory adolescents with cerebral palsy. Resistance training did not improve muscle strength, activity, or participation. Ninety percent of participants experienced an adverse event. Most adverse events were expected and no serious adverse events were reported.

Original language	English
Pages (from-to)	1283-1293
Number of pages	11
Journal	Developmental Medicine and Child Neurology
Volume	62
Issue number	11
DOIs	https://doi.org/10.1111/dmcn.14601
Publication status	Published - 1 Nov 2020

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@article{08259b61169d448688c1a11064eb81b4,

title = "Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial",

abstract = "Aim: To evaluate the effect of progressive resistance training of the ankle plantarflexors on gait efficiency, activity, and participation in adolescents with cerebral palsy (CP). Method: Sixty-four adolescents (10–19y; 27 females, 37 males; Gross Motor Function Classification System [GMFCS] levels I–III) were randomized to 30 sessions of resistance training (10 supervised and 20 unsupervised home sessions) over 10 weeks or usual care. The primary outcome was gait efficiency indicated by net nondimensional oxygen cost (NNcost). Secondary outcomes included physical activity, gross motor function, participation, muscle strength, muscle and tendon size, and muscle and tendon stiffness. Analysis was intention-to-treat. Results: Median attendance at the 10 supervised sessions was 80% (range 40–100%). There was no between-group difference in NNcost at 10 (mean difference: 0.02, 95% confidence interval [CI] –0.07 to 0.11, p=0.696) or 22 weeks (mean difference: –0.08, 95% CI –0.18 to 0.03, p=0.158). There was also no evidence of between-group differences in secondary outcomes at 10 or 22 weeks. There were 123 adverse events reported by 27 participants in the resistance training group. Interpretation: We found that 10 supervised sessions and 20 home sessions of progressive resistance training of the ankle plantarflexors did not improve gait efficiency, muscle strength, activity, participation, or any biomechanical outcome among adolescents with CP. What this paper adds: Thirty sessions of progressive resistance training of the ankle plantarflexors over 10 weeks did not improve gait efficiency among ambulatory adolescents with cerebral palsy. Resistance training did not improve muscle strength, activity, or participation. Ninety percent of participants experienced an adverse event. Most adverse events were expected and no serious adverse events were reported.",

author = "Ryan, {Jennifer M.} and Grace Lavelle and Nicola Theis and Marika Noorkoiv and Cherry Kilbride and Thomas Korff and Vasilios Baltzopoulos and Adam Shortland and Wendy Levin",

year = "2020",

month = nov,

day = "1",

doi = "10.1111/dmcn.14601",

language = "English",

volume = "62",

pages = "1283--1293",

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T1 - Progressive resistance training for adolescents with cerebral palsy

T2 - the STAR randomized controlled trial

AU - Ryan, Jennifer M.

AU - Lavelle, Grace

AU - Theis, Nicola

AU - Noorkoiv, Marika

AU - Kilbride, Cherry

AU - Korff, Thomas

AU - Baltzopoulos, Vasilios

AU - Shortland, Adam

AU - Levin, Wendy

PY - 2020/11/1

Y1 - 2020/11/1

N2 - Aim: To evaluate the effect of progressive resistance training of the ankle plantarflexors on gait efficiency, activity, and participation in adolescents with cerebral palsy (CP). Method: Sixty-four adolescents (10–19y; 27 females, 37 males; Gross Motor Function Classification System [GMFCS] levels I–III) were randomized to 30 sessions of resistance training (10 supervised and 20 unsupervised home sessions) over 10 weeks or usual care. The primary outcome was gait efficiency indicated by net nondimensional oxygen cost (NNcost). Secondary outcomes included physical activity, gross motor function, participation, muscle strength, muscle and tendon size, and muscle and tendon stiffness. Analysis was intention-to-treat. Results: Median attendance at the 10 supervised sessions was 80% (range 40–100%). There was no between-group difference in NNcost at 10 (mean difference: 0.02, 95% confidence interval [CI] –0.07 to 0.11, p=0.696) or 22 weeks (mean difference: –0.08, 95% CI –0.18 to 0.03, p=0.158). There was also no evidence of between-group differences in secondary outcomes at 10 or 22 weeks. There were 123 adverse events reported by 27 participants in the resistance training group. Interpretation: We found that 10 supervised sessions and 20 home sessions of progressive resistance training of the ankle plantarflexors did not improve gait efficiency, muscle strength, activity, participation, or any biomechanical outcome among adolescents with CP. What this paper adds: Thirty sessions of progressive resistance training of the ankle plantarflexors over 10 weeks did not improve gait efficiency among ambulatory adolescents with cerebral palsy. Resistance training did not improve muscle strength, activity, or participation. Ninety percent of participants experienced an adverse event. Most adverse events were expected and no serious adverse events were reported.

AB - Aim: To evaluate the effect of progressive resistance training of the ankle plantarflexors on gait efficiency, activity, and participation in adolescents with cerebral palsy (CP). Method: Sixty-four adolescents (10–19y; 27 females, 37 males; Gross Motor Function Classification System [GMFCS] levels I–III) were randomized to 30 sessions of resistance training (10 supervised and 20 unsupervised home sessions) over 10 weeks or usual care. The primary outcome was gait efficiency indicated by net nondimensional oxygen cost (NNcost). Secondary outcomes included physical activity, gross motor function, participation, muscle strength, muscle and tendon size, and muscle and tendon stiffness. Analysis was intention-to-treat. Results: Median attendance at the 10 supervised sessions was 80% (range 40–100%). There was no between-group difference in NNcost at 10 (mean difference: 0.02, 95% confidence interval [CI] –0.07 to 0.11, p=0.696) or 22 weeks (mean difference: –0.08, 95% CI –0.18 to 0.03, p=0.158). There was also no evidence of between-group differences in secondary outcomes at 10 or 22 weeks. There were 123 adverse events reported by 27 participants in the resistance training group. Interpretation: We found that 10 supervised sessions and 20 home sessions of progressive resistance training of the ankle plantarflexors did not improve gait efficiency, muscle strength, activity, participation, or any biomechanical outcome among adolescents with CP. What this paper adds: Thirty sessions of progressive resistance training of the ankle plantarflexors over 10 weeks did not improve gait efficiency among ambulatory adolescents with cerebral palsy. Resistance training did not improve muscle strength, activity, or participation. Ninety percent of participants experienced an adverse event. Most adverse events were expected and no serious adverse events were reported.

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U2 - 10.1111/dmcn.14601

DO - 10.1111/dmcn.14601

M3 - Article

C2 - 32588919

AN - SCOPUS:85087150827

SN - 0012-1622

VL - 62

SP - 1283

EP - 1293

JO - Developmental Medicine and Child Neurology

JF - Developmental Medicine and Child Neurology

IS - 11

ER -

Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial

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