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Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy: A randomized pilot study
Abstract
OBJECTIVE: To compare the effects of physical rehabilitation with (PRT) and without (CON) progressive resistance training following treatment of spastic plantarflexors with botulinum toxin type A (BoNT) in children with cerebral palsy (CP). METHODS: Fourteen children with CP performed supervised PRT (n=7) or CON (n=7) two times per week for 12 weeks, following the BoNT-treatment. Outcome measurements were performed at baseline (pre BoNT), and 4 and 12 weeks post BoNT. They consisted of: ankle muscle function (maximal torque and submaximal torque steadiness of isometric ankle dorsi- and plantarflexion and associated ankle muscle [EMG] activity), gait function (3-dimensional gait analysis), balance function (sway analysis), gross motor function (GMFM-66), and spasticity (modified Ashworth). RESULTS: Submaximal torque control (torque steadiness) of isometric dorsiflexion improved similarly in the two groups, and the improvement was related to the reduction in antagonist (soleus) co-activity (P< 0.05). Maximal plantarflexion torque increased after PRT, whereas a reduction was seen after CON (P< 0.05). No changes in function were observed. CONCLUSIONS: Both types of physical rehabilitation in combination with BoNT-treatment improved antagonist (ankle dorsiflexion) torque-control to the same extent - which was related to the reduction in antagonist co-activity - but only rehabilitation with PRT increased maximal plantarflexion torque.
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Performing resisted ankle and knee exercises for a total of 6 hours (two 15 min sessions/wk for 12wks), combined with rehabilitation (12h), did not improve standing balance (BF&S; as measured by stabilometry [sway path length], p > 0.05) or gait kinematics (BF&S) in ambulant children with CP (GMFCS I), aged 5 to 14 years.
“Performing resisted ankle and knee exercises for a total of 6 hours (two 15 min sessions/wk for 12wks), combined with rehabilitation (12h), did not improve standing balance (BF&S; as measured by stabilometry [sway path length], p > 0.05) or gait kinematics (BF&S) in ambulant children with CP (GMFCS I), aged 5 to 14 years (level II, conduct strong; see online Table SIIIa). 51”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [51]
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Metadata
- Authors
- Bandholm, T., Jensen, B. R., Nielsen, L. M., Rasmussen, H., Bencke, J., Curtis, D., Pedersen, S. A., & Sonne-Holm, S.
- Affiliations
- Hvidovre Hospital (DK)
- University of Copenhagen (DK)
- Gait Analysis Laboratory, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
- Corresponding author
- Bandholm, Thomas
- Venue
- NeuroRehabilitation
- Publisher
- SAGE Publications
- Published
- 2012-06-01
- Volume
- 30
- Issue
- 4
- Pages
- 277-286
- ISSN
- 1053-8135 (ISSN-L)
- 1878-6448
- OpenAlex
- W1801973083
- Cited by
- 27
- References
- 46
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 1 · 2018: 1 · 2017: 4 · 2016: 4 · 2015: 1 · 2014: 2 · 2013: 3 · 2012: 1
- FWCI
- 1.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurorehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Gentofte Hospital
- Elsass Fonden
- Topics
- Health Sciences › Medicine › Rehabilitation › Cerebral Palsy and Movement Disorders
- Health Sciences › Medicine › Clinical Neurology › Botulinum Toxin and Related Neurological Disorders
- Health Sciences › Medicine › Genetics (clinical) › Neurogenetic and Muscular Disorders Research
- Keywords
- cerebral palsy, botulinum toxin type A, progressive resistance training, spasticity, ankle plantar flexors, ankle dorsiflexion, torque control, soleus muscle, gait, balance, gross motor function, children
- MeSH terms
- Analysis of Variance, Ankle Joint, Cerebral Palsy, Child, Disability Evaluation, Electromyography, Female, Gait, Humans, Male, Neuromuscular Agents, Pilot Projects, Retrospective Studies, Time Factors, Treatment Outcome, Muscle, Skeletal, Botulinum Toxins, Type A, Resistance Training
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