Effects of strength training on mobility in adults with cerebral palsy: A systematic review

Background: Many adults with cerebral palsy report experiencing early-onset decline in mobility and independence. The role of strength training to combat this is not well understood. Objective/hypothesis: To examine the effects of strength-training interventions on muscle strength and functional outcomes for adults with CP using the ICF framework. Methods: A systematic review was conducted following standardized guidelines and using key words including: adults, cerebral palsy in combination with resistance or strength training, and ambulation and function related key words. Selection criteria included: (a) adults (mean age 18+ years) with CP, (b) strength training intervention, and (c) at least one activity or participation outcome measure. 26 retrieved articles were retained for full review. Data on strength training protocols were extracted and compared to national guidelines. Outcome measures were classified within ICF domains. Results: Six articles met the inclusion criteria. These articles were of high research quality and consistent with recommended training protocols for adults with CP. Positive gains in muscle strength were reported across studies. Changes within the activity ICF dimension were inconsistent, with 2 of the 6 studies observing increases in self-selected walking speed. Conclusions: Findings indicate training benefits for adults with CP. However, a small sample (n = 111 across all included studies) and the absence of extended training regimens and follow-up hindered conclusive results. High consistency in training protocols and outcome measures allowed for critical discussion on key research questions regarding the impact of strength training and subsequent gains in function within ICF domains. (C) 2016 Elsevier Inc. All rights reserved.