Enhancing muscular fitness and higher levels of muscular strength causes significantly better cardiometabolic risk factor profiles, lower risk of all-cause mortality, fewer cardiovascular disease events, and lower risk of developing functional limitations. In CP, muscle weakness is a primary impairment, and there is strong evidence showing that children with CP are significantly weaker than children with typical development [45–52]. In the past, strength training was considered to be contraindicated in children with CP because it was thought to increase muscles stiffness and result in an increase in spasticity. However, studies have found no change in spasticity during or after training, which supports the current belief that strength training for persons with spasticity is not contraindicated [53–55]. Muscle strength training studies have shown that training may strengthen muscles without adverse effects in children and adolescents with CP. The majority of participants were spastic diplegic or hemiplegic distribution. These trials are evidence for benefit of strength training programs that improve strength [56]. Also, there is an evidence that targeted strength training improves spasticity. Therefore, in conjunction with cardiorespiratory fitness, target muscle strengthening in children, adolescents, and adults with CP is imperative [57]. As for children with typical development, resistance training has observable benefits in strength among children, adolescents, and adults with CP [58]. There is inadequate evidence to show changes in activity or participating in everyday life. However, there are strong indications that strength training programs play an important role in the habilitation of individuals with CP [7]. Isokinetics has been used in testing and performance enhancement for over 30 years. In 1967, some authors introduced the concept of isokinetic exercise training and rehabilitation. Isokinetics are frequently chosen because of their inherent patient safety and objectivity. Isokinetic represents a match between mechanically imposed velocity and the subject movement that contacts against a controlled angular velocity. Therefore, through accommodating resistance, the muscle contracts at its maximal capability at all points throughout the range of motion [59]. Endurance exercises are considered as exercises that are done in a time limit of a person’s ability to maintain either a specific force or power involving muscular contractions. Several studies have found out that endurance exercises can greatly increase strength in the muscles by adding specific weight training to their programs. Strength development through endurance training is important for the prevention and rehabilitation of injuries and for improving sport performance. Strength is also important for maintenance of functional capacity; with aging or injury, there is catabolic breakdown of the muscle connective tissue, resistance training presents the only natural method to offset such wasting conditions. Resistance exercise is a very common type of endurance training, which can improve the muscle strength and give a good balance to our bodies [60–65]. Strength training also increase the power of weak antagonist muscles and of the spastic agonists. Improvements with various modalities ranged from 19.6% with isokinetic strengthening to over 100% with training machines and free weights [66–70]. The nature of the relationship between strength and function is of considerable relevance to clinical practice. Task-oriented weight-bearing strength training for children with CP was effective in increasing strength and functional performance. Gains in strength improve functional motor performance, if strengthening exercises includes more functional closed kinetic chain exercises. In these exercises, the subject is weight bearing through the feet, and the body mass is raised and lowered over the feet by concentric and eccentric action of lower limb muscles, such as sit-to-stand and walking [71].
Nilay Çömük Balcı
Comentarios