Movement and Strength of Children with Cerebral Palsy

Cerebral palsy is defined as non-progressive lesions or damage in the brain at or before birth, leading to impairments in movement and posture.

These impairments vary from person to person, but the majority of children with cerebral palsy experience differences in muscle strength which can lead to many functional challenges throughout their lives.

As discussed in the article above, strength training in children with cerebral palsy has been shown to be beneficial particularly in improving their motor activity. It can be confusing for caregivers to objectively determine what type and frequency of strength training activity would be helpful. Evaluations such as the Pediatric Functional Muscle Test can be useful for clinicians and therapists for in-the-moment information, but provides limited information and applications for continued training.

It is important to know the basic principles of strength training with children with cerebral palsy before starting any program.

Strength training for children with cerebral palsy

1. Repetition!
   Children with cerebral palsy often have difficulty activating certain muscle groups. In order to effectively strengthen these muscle groups, training should focus on repetition of postures or activities that encourage movement in these areas.

2. Find the right tools!
   In order for a training program to be effective the child needs to be able to understand and engage in the instructed movements.

3. Positioning!
   Engaging in the activity with good posture will enhance the effectiveness of the training

4. Adaptation!
   Make sure the training activity is an appropriate amount of challenge for the child's abilities. Remove too-complex elements or add challenge to too-easy elements to ensure they stay motivated.

5. Engagement!
   Training that is relevant to the child's interests will have better long-term effects. Ensure they have a say in their program, either catering a routine to include relevant personal touches or letting the child pick the day's activity are surefire strategies.

Goals of strength training for CP

Not only can strength training activities for children with cerebral palsy strengthen muscle groups, these effects can translate into improved function in daily life. Stronger and more coordinated muscles may lend to greater independence in self-care skills and feelings of capability and self-confidence.

The benefits of strengthening for pediatric CP are clear. Look to your rehabilitation team for additional tips to get started on an effective exercise program.

Dodd KJ, Taylor NF, Damiano DL. A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. Arch Phys Med Rehabil. 2002;83(8):1157-1164. doi:10.1053/apmr.2002.34286