The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Any benefits of strength training in cerebral palsy?

    Not in children and adolescents according to this review by researchers at The University of Sydney, in Australia.

    First, the details.

    • 6 studies were reviewed.
      • Data from 5 were included in a meta-analysis.
    • Participants included children with spastic cerebral palsy between school age and 20 years.
    • Strengthening involved repetitive, strong, or effortful muscle contractions and progressed as ability changed, such as biofeedback, electrical stimulation, and progressive resistance exercise.

    And, the results.

    • Strengthening had no effect on strength or walking speed.
    • There was a small statistically significant but not clinically worthwhile effect on Gross Motor Function.
    • Only 1 study measured spasticity but didn’t report the between-group results.

    The bottom line?
    The authors concluded, “In children and adolescents with cerebral palsy who are walking, the current evidence suggests that strengthening interventions are neither effective nor worthwhile.”

    Dr. Diane L Damiano, from Washington University, in St. Louis, Missouri tells us, “Physical therapy, along with orthopedic surgery, has been the mainstay of the rehabilitation management of cerebral palsy for decades. Pediatric therapy has a clear and important role in helping children and their families cope more effectively with the disability through education, advocacy, functional training, and recommendations for adjunctive devices or therapies to optimize function.”

    “What is less clear,” she continues, “is the extent to which physical therapy can alter the motor prognosis or make a clinically significant change in the level of disability or degree of participation for any given child. Traditional therapy approaches have been shown for the most part to be marginally beneficial and demand serious reconsideration by those who still advocate them.”

    Here are 2 other reports from 2008.

    In Brazil, 9 children with spastic hemiplegic cerebral palsy underwent 24 sessions of wrist muscles strengthening in the extended wrist range aided by electrostimulation. No changes were observed in passive stiffness, wrist angle, or hand function.

    In Finland, the effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy was reviewed. The high-quality reviews reported some benefit from strength training, constraint-induced movement therapy, or hippotherapy (physical, occupational, and speech therapy that uses equine movement). There was insufficient evidence on comprehensive physiotherapy and occupational therapy interventions.

    5/26/09 19:05 JR

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