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Exercise training increases physical fitness for children with cerebral palsy
REFERENCES 1. DiFranza JR, Savageau JA, Fletcher K, O’Loughlin J, Pbert L, Ockene JK, et al. Symptoms of tobacco dependence after brief intermittent use: the development and assessment of nicotine dependence in youth-2 study. Arch Pediatr Adolesc Med 2007;161:704-10. 2. Dalton MA, Sargent JD, Beach ML, Titus-Ernstoff L, Gibson JJ, Ahrens MB, et al. Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study. Lancet 2003;362:281-5. 3. Lovato C, Linn G, Stead LF, Best A. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database Syst Rev 2003(4): CD003439. 4. van den Bree MB, Whitmer MD, Pickworth WB. Predictors of smoking development in a population-based sample of adolescents: a prospective study. J Adolesc Health 2004;35:172-81. 5. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2007. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; October 2007.
Exercise training increases physical fitness for children with cerebral palsy Verschuren O, Ketelaar M, Gorter JW, Helders PJ, Uiterwaal CS, Takken T. Exercise training program in children and adolescents with cerebral palsy: a randomized controlled trial. Arch Pediatr Adolesc Med 2007;161:1075– 81 Among children and adolescents with cerebral palsy, does an 8-month training program with standardized exercises improve aerobic and anaerobic capacity compared with no additional intervention?
Question
Design
Randomized controlled trial.
ity2,3 than their able-bodied peers and can have significant rates of risk of overweight.4 In addition, adults with cerebral palsy are at risk of losing ambulatory skills and other functional independence as they age. In response to these concerns, there have been a number of recent studies that have examined the benefits of exercise for individuals with cerebral palsy.5 The training programs have focused on strengthening and aerobic training and have generally shown positive results. This study by Verschuren et al used a circuit training program that contained functional tasks designed to elicit both aerobic and anaerobic training responses. As in other studies, participants in this trial had significant improvement in aerobic and anaerobic capacity, as well as agility and muscle strength, on the basis of functional testing. There was also significant improvement in participation and health-related quality of life. At 4 months after intervention, the subjects had decreased in most measures, although not to baseline. The authors used functional measures for their outcomes, which may lack some of the precision of laboratory measures, but are much more practical for a clinical setting. This study is important in that it describes a functional exercise program requiring no special equipment that can be easily adapted to the child’s skill level and the increased physical fitness that results. Although long-term effects are not known, one can only assume that an early introduction to a lifestyle that includes fitness would be beneficial for future health and function for children with cerebral palsy.
Setting Four schools for special education in the Netherlands.
Joseph E. Hornyak, MD, PhD Edward A. Hurvitz, MD
Participants 86 children with cerebral palsy, aged 7 to 18 years, classified at Gross Motor Function Classification System level I or II. Intervention The training group met twice per week for 45
minutes to circuit train in a group format that focused on aerobic and anaerobic exercises. Outcomes Aerobic capacity was assessed by the 10-m shuttle run test, and anaerobic capacity was assessed by the muscle power sprint test. Secondary outcome measures included agility, muscle strength, self-competence, gross motor function, participation level, and health-related quality of life. Main results A significant training effect was found for aerobic
(P ⬍ .001) and anaerobic capacity (P ⫽ .004). A significant effect was also found for agility (P ⬍ .001), muscle strength (P ⬍ .001), and athletic competence (P ⫽ .005). The intensity of participation showed a similar effect for formal (P ⬍ .001), overall (P ⫽ .002), physical (P ⫽ .005), and skilled-based activities (P ⫽ .001). On the health-related quality of life measure, a significant improvement was found for the motor (P ⫽ .001), autonomy (P ⫽ .02), and cognition (P ⫽ .04) domains.
An exercise training program improves physical fitness, participation level, and quality of life in children with cerebral palsy when added to standard care.
Conclusions
Comment Studies have suggested that individuals with cerebral palsy are less active1 and have lower aerobic capac-
Clinical Research Abstracts for Pediatricians
University of Michigan Ann Arbor, Michigan
REFERENCES 1. Maher CA, Williams MT, Olds T, Lane AE. Physical and sedentary activity in adolescents with cerebral palsy. Dev Med Child Neurol 2007;49:450-7. 2. Lundberg A. Longitudinal study of physical working capacity of young people with spastic cerebral palsy. Dev Med Child Neurol 1984;26:328-34. 3. Lundberg A. Maximal aerobic capacity of young people with spastic cerebral palsy. Dev Med Child Neurol 1978;20:205-10. 4. Hurvitz EA, Green LB, Hornyak JE, Khurana SR, Koch LG. Body mass index measures in children with cerebral palsy related to gross motor function classification: A clinic-based study. Am J Phys Med Rehabil (in press). 5. Verschuren O, Ketelaar M, Takken T, Helders PJ, Gorter JW. Exercise programs for children with cerebral palsy: A systematic review of the literature. Am J Phys Med Rehabil (in press).
Honey improves cough in children compared to no treatment Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 2007;161:1140-6. Question Among children with nocturnal cough and sleep difficulty associated with upper respiratory tract infections, does a single nocturnal dose of buckwheat honey or honeyflavored dextromethorphan (DM) decrease cough and improve sleep compared with no treatment? Design
Randomized, partially double-blinded clinical trial. 739
Exercise training increases physical fitness for children with cerebral palsy Verschuren O, Ketelaar M, Gorter JW, Helders PJ, Uiterwaal CS, Takken T. Exercise training program in children and adolescents with cerebral palsy: a randomized controlled trial. Arch Pediatr Adolesc Med 2007;161:1075– 81 Among children and adolescents with cerebral palsy, does an 8-month training program with standardized exercises improve aerobic and anaerobic capacity compared with no additional intervention?
Question
Design
Randomized controlled trial.
ity2,3 than their able-bodied peers and can have significant rates of risk of overweight.4 In addition, adults with cerebral palsy are at risk of losing ambulatory skills and other functional independence as they age. In response to these concerns, there have been a number of recent studies that have examined the benefits of exercise for individuals with cerebral palsy.5 The training programs have focused on strengthening and aerobic training and have generally shown positive results. This study by Verschuren et al used a circuit training program that contained functional tasks designed to elicit both aerobic and anaerobic training responses. As in other studies, participants in this trial had significant improvement in aerobic and anaerobic capacity, as well as agility and muscle strength, on the basis of functional testing. There was also significant improvement in participation and health-related quality of life. At 4 months after intervention, the subjects had decreased in most measures, although not to baseline. The authors used functional measures for their outcomes, which may lack some of the precision of laboratory measures, but are much more practical for a clinical setting. This study is important in that it describes a functional exercise program requiring no special equipment that can be easily adapted to the child’s skill level and the increased physical fitness that results. Although long-term effects are not known, one can only assume that an early introduction to a lifestyle that includes fitness would be beneficial for future health and function for children with cerebral palsy.
Setting Four schools for special education in the Netherlands.
Joseph E. Hornyak, MD, PhD Edward A. Hurvitz, MD
Participants 86 children with cerebral palsy, aged 7 to 18 years, classified at Gross Motor Function Classification System level I or II. Intervention The training group met twice per week for 45
minutes to circuit train in a group format that focused on aerobic and anaerobic exercises. Outcomes Aerobic capacity was assessed by the 10-m shuttle run test, and anaerobic capacity was assessed by the muscle power sprint test. Secondary outcome measures included agility, muscle strength, self-competence, gross motor function, participation level, and health-related quality of life. Main results A significant training effect was found for aerobic
(P ⬍ .001) and anaerobic capacity (P ⫽ .004). A significant effect was also found for agility (P ⬍ .001), muscle strength (P ⬍ .001), and athletic competence (P ⫽ .005). The intensity of participation showed a similar effect for formal (P ⬍ .001), overall (P ⫽ .002), physical (P ⫽ .005), and skilled-based activities (P ⫽ .001). On the health-related quality of life measure, a significant improvement was found for the motor (P ⫽ .001), autonomy (P ⫽ .02), and cognition (P ⫽ .04) domains.
An exercise training program improves physical fitness, participation level, and quality of life in children with cerebral palsy when added to standard care.
Conclusions
Comment Studies have suggested that individuals with cerebral palsy are less active1 and have lower aerobic capac-
Clinical Research Abstracts for Pediatricians
University of Michigan Ann Arbor, Michigan
REFERENCES 1. Maher CA, Williams MT, Olds T, Lane AE. Physical and sedentary activity in adolescents with cerebral palsy. Dev Med Child Neurol 2007;49:450-7. 2. Lundberg A. Longitudinal study of physical working capacity of young people with spastic cerebral palsy. Dev Med Child Neurol 1984;26:328-34. 3. Lundberg A. Maximal aerobic capacity of young people with spastic cerebral palsy. Dev Med Child Neurol 1978;20:205-10. 4. Hurvitz EA, Green LB, Hornyak JE, Khurana SR, Koch LG. Body mass index measures in children with cerebral palsy related to gross motor function classification: A clinic-based study. Am J Phys Med Rehabil (in press). 5. Verschuren O, Ketelaar M, Takken T, Helders PJ, Gorter JW. Exercise programs for children with cerebral palsy: A systematic review of the literature. Am J Phys Med Rehabil (in press).
Honey improves cough in children compared to no treatment Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 2007;161:1140-6. Question Among children with nocturnal cough and sleep difficulty associated with upper respiratory tract infections, does a single nocturnal dose of buckwheat honey or honeyflavored dextromethorphan (DM) decrease cough and improve sleep compared with no treatment? Design
Randomized, partially double-blinded clinical trial. 739