Exercising at Home Improves Walking Ability in Children with CP, Small Study Finds

A structured home-based exercise program can improve walking ability in children with cerebral palsy (CP), a new has study found.

Results of the research, “Structured home-based exercise program for improving walking ability in ambulant children with cerebral palsy,” were published in Journal of Pediatric Rehabilitation Medicine.

Physical exercise programs and therapies can be beneficial for people with CP, but participation can require dealing with numerous financial and logistical obstacles. Home-based exercise programs can sidestep some of these obstacles.

The study details results from a clinical trial in Malaysia (ACTRN12616001013459) in 11 children with CP (seven male, four female, average age 10.25 years) who participated in an eight-week, structured, home-based exercise program that was specifically designed for children with CP who are able to walk.

The program has three phases:

• Phase 1 (pre-intervention), in which patients become familiar with the program and undergo physical assessments (at four weekly intervals) prior to beginning the intervention;
• Phase 2 (intervention), when the program is implemented at home and participants undergo physical assessments three times over eight weeks;
• Phase 3 (post-intervention), at which time follow-up assessments are conducted at one and three months after the intervention.

The home-based program is composed of three main exercise modules for the upper and lower limb muscles: aerobic fitness training, muscle strengthening, and stretching exercises.

Motor function was measured with the gross motor function measure-66 (GMFM-66), walking ability was assessed via 6-minute walk test (6MWT), and movement efficiency was measured with the physiological cost index (PCI).

Comparing average scores before and during the intervention, 6MWT total distance increased significantly from 334 to 381 meters (365 to 416 yards), as did walking speed in this test, from 56.0 to 63.4 meters a minute (61 to 69 yards minute). After the program (Phase 3), these values decreased slightly, but still were higher than before the intervention (378 meters, or 413 yards) or Phase 1 (62.9 meters per minute, 68 yards per minute).

Similarly, average GMFM-66 scores increased significantly from before (91.88), during (93.38), and after (95.25) the program. But analysis of effect size (a statistical tool that basically determines whether two groups are different) suggested that the change in walking tests was more pronounced.

PCI scores, which evaluate movement efficiency, improved slightly, but the difference was not statistically significant.

“Overall,” the researchers wrote, “these results showed the positive effect of [the structured home-based exercise program] on the walking distance, speed and GMFM-66 score of the study participants.”

The researchers also noted that, according to logs of exercise turned in by seven of the participants, the average time for a single exercise session increased from 16.9 minutes in the second week of the program to 23.5 in the seventh week, indicating that the participants’ endurance increased over the course of the program.

This was a very small study, so further research will be needed to reinforce  the results. Still, the researchers concluded that the program “is a potential, practical, and structured home-based exercise programme that can improve the walking function of children with ambulant CP.”