Effects of Quadriceps Femoris Muscle Strengthening on Crouch Gait in Children With Spastic Diplegia

Abstract

Background and Purpose. Despite evidence of weakness in children with cerebral palsy, the use of strength training in this population remains controversial. Subjects. Fourteen children with spastic diplegia, ranging in age from 6 to 14 years (X̅=9.1, SD=2.5), participated in a bilateral quadriceps femoris muscle strengthening program. Methods. The children exercised three times per week for 6 weeks using ankle weights at loads of approximately 65% of each child's maximum isotonic force production. The maximal voluntary contraction of the quadriceps femoris muscles was measured before, at the midpoint of, and immediately following the exercise program at 30, 60, and 90 degrees of knee flexion. Gait analyses were performed before and after the strengthening program to determine whether quadriceps femoris muscle strengthening influenced gait. Results. Children with spastic diplegia can increase quadriceps femoris muscle strength through heavy resistance exercise. Repeated-measures analysis of variance and multivariate analysis of variance procedures were used to assess changes in force and in gait variables. Improvement in the degree of crouch at initial floor contact at the freely selected speed and an increase in stride length at free and fast speeds were found. Conclusion and Discussion. These findings suggest that resistance exercise is an effective treatment strategy and as such should be considered as one component in the habilitation of children with cerebral palsy.