The effects of an exercise training program on hand and wrist strength, and function, and activities of daily living, in adults with severe Cerebral Palsy

• Published in: Research in developmental disabilities 2013-12, Vol.34 (12), p.4343-4354
• Main Authors: Hutzler, Yeshayahu, Rodríguez, Beatriz Lamela, Laiz, Nuria Mendoza, Díez, Isabel, Barak, Sharon
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Assessment; Biological and medical sciences; Cerebral palsy; Cerebral Palsy - complications; Cerebral Palsy - rehabilitation; Exercise Therapy - methods; Feasibility; Feasibility Studies; Female; Fitness; Hand Strength - physiology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Middle Aged; Motor Skills Disorders - etiology; Motor Skills Disorders - rehabilitation; Muscle Strength - physiology; Muscle Strength Dynamometer - statistics & numerical data; Nervous system (semeiology, syndromes); Neurology; Physical activity; Physiotherapy; Pinch Strength - physiology; Rehabilitation; Reliability; Reproducibility of Results; Severity of Illness Index; Treatment Outcome; Upper extremity; Wrist - physiology; Wrists
• ISSN: 0891-4222; 1873-3379
• DOI: 10.1016/j.ridd.2013.09.015

•The measurement of hand and wrist strength with the Biometrics system was reliable.•An intensive strength training program was feasible in non-ambulatory adults with CP.•The strength training program significantly increased strength and manual motor function.•Most strength and motor function variables were associated. The purpose of the current study was to establish measurement reliability in adults with Cerebral Palsy (CP), and to examine the feasibility and outcomes of an upper extremity strength training program (three times per week for 90min each time). A control group design mixed with a prospective time series design for the intervention group was completed, including a pre-test, a post-test after a 12-week intervention period, and a follow-up in the intervention group after an additional 10-week period. Seventeen adults with CP with severe motor impairment took part in the study (10 in the intervention and seven in the control group). The test battery was comprised of wrist and hand dynamometry; dominant hand upper-extremity function measures (Jebsen Hand Function Test=JHFT, Minnesota Manual Dexterity Test=MMDT, and the Nine Hole Peg Test=NHPT); and activity of daily living with the Barthel Index. The results indicated that in both the control and the intervention groups, the strength tests exhibited good-to-excellent reliability during pre-test and post-test. The group comparison revealed that while in the pre-test no between-group differences existed, in the post-test the strength training group demonstrated significantly higher values in five out of eight strength measures, as well as in the MMDT. Discontinuing the program for eight weeks reversed the effects almost to baseline. In conclusion, the outcomes demonstrated the reliability of the assessments utilized in this study, as well as the feasibility of the strength training program, in adults with severe motor impairment due to CP.