Resistance Training for Cerebral Palsy

(RIPT Trial)

Overseen By Elizabeth Condliffe

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Calgary

Disqualifiers: Acute pathology, High neuromotor impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 12 weeks

24 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether a special strength training program can help children with cerebral palsy improve motor skills and achieve personal goals. Physiotherapists and fitness experts lead the program, called Resistance Intensive Personal Training, in a community setting. The trial also examines the feasibility of offering this type of program. Suitable participants are children with cerebral palsy, aged 8 to 17, who can follow directions in English and exert maximum effort during training. As an unphased trial, this study provides a unique opportunity for participants to contribute to innovative research that could enhance future therapies for cerebral palsy.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this resistance training program is safe for youth with cerebral palsy?

Research has shown that resistance training is generally safe and well-tolerated for people with cerebral palsy (CP). Studies have found that this exercise can significantly increase muscle strength without negative side effects, confirming its safety for participants with CP.

In past research, participants with CP who engaged in resistance training did not report any serious problems. This suggests that the exercises did not cause harm or unexpected issues. Instead, they often resulted in stronger muscles, which is a positive outcome.

Overall, resistance training appears to be a safe and effective way to improve physical abilities in people with CP. It builds strength without causing harm, making it a promising option for enhancing motor skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Resistance Intensive Personal Training (RIPT) is unique because it offers a structured, intensive approach to strength training specifically tailored for individuals with cerebral palsy. Unlike traditional physical therapy methods, which often focus on general mobility and flexibility, RIPT provides personalized one-on-one power training sessions within a supportive group setting. Researchers are excited about this method because it combines the benefits of social interaction with targeted strength-building exercises, potentially leading to improved motor functions and overall quality of life for participants. Moreover, the frequent, consistent training schedule over 12 weeks may help reinforce muscle memory and enhance functional gains more effectively than less intensive programs.

What evidence suggests that Resistance Intensive Personal Training is effective for improving motor function in youth with cerebral palsy?

Research shows that strength training can help children with cerebral palsy improve muscle strength and shape. Studies have found that exercise programs enhance movement skills and physical fitness for individuals with this condition. Previous trials using similar training methods demonstrated better muscle strength and changes in muscle shape. These results suggest that the program being tested in this trial, Resistance Intensive Personal Training (RIPT), might help young people with cerebral palsy improve their movement abilities and achieve their personal goals. ^{2 4 6 7 8}

Who Is on the Research Team?

Elizabeth Condliffe

Principal Investigator

University of Calgary

Are You a Good Fit for This Trial?

This trial is for young people with Cerebral Palsy, aged 8 to 17 years old, who can understand English and are capable of exerting maximum effort in physical activities. It's not suitable for those who don't meet these age or communication requirements.

Inclusion Criteria

able to follow directions in English

I am 17 years old or younger.

I can perform activities requiring my full effort.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo Resistance Intensive Personal Training (RIPT) for 12 weeks, 2-3 days per week, with 1:1 support in a group setting

12 weeks

2-3 visits per week (in-person)

Follow-up

Participants and families complete assessments and participate in focus groups to evaluate the program's effectiveness and feasibility

2 weeks

1-2 visits (in-person)

Evaluation

Evaluation of outcomes using Goal Attainment Scale, EQ-5D-Y, and other measures to assess the impact of the training program

14 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Resistance Intensive Personal Training

Trial Overview

The study tests a Resistance Intensive Personal Training program designed to improve muscle strength and motor function in youth with CP. The effectiveness and feasibility of delivering this training through a community-hospital partnership are being evaluated.

How Is the Trial Designed?

Group I: Resistance Intensive Personal Training (RIPT) Experimental Treatment 1 Intervention

All participants will participate in this arm involving 12 weeks of training 2-3 days/week in a group setting with each session involving 1:1 support for each participant's power training.

Who Is Running the Clinical Trial?

University of Calgary

Lead Sponsor

Trials

827

Recruited

902,000+

Published Research Related to This Trial

In a study involving 14 children with cerebral palsy, both progressive resistance training (PRT) and conventional rehabilitation (CON) improved ankle muscle control after treatment with botulinum toxin type A, particularly by reducing antagonist muscle co-activity.

However, only the PRT group showed a significant increase in maximal plantarflexion torque, highlighting the added benefits of resistance training in enhancing muscle strength following BoNT treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy: a randomized pilot study. Bandholm, T., Jensen, BR., Nielsen, LM., et al.[2012]

Strength training has been shown to significantly improve muscular strength in athletes with cerebral palsy (CP), based on a systematic review of 30 studies, although evidence for functional improvements remains limited.

There is a lack of research on specific training interventions for enhancing sports performance in CP athletes, suggesting that coaches should prioritize building muscular strength before tailoring programs to specific sports.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strength Training to Improve Performance in Athletes With Cerebral Palsy: A Systematic Review of Current Evidence. Fleeton, JRM., Sanders, RH., Fornusek, C.[2021]

Velocity training (VT) significantly improved muscle power, walking speed, and functional walking performance in youth with cerebral palsy compared to traditional strength training (ST), which did not show these benefits.

Both VT and ST increased isokinetic strength, but only VT led to specific adaptations in muscle architecture, such as increased fascicle length, highlighting the importance of incorporating higher velocity movements in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Differential adaptations of muscle architecture to high-velocity versus traditional strength training in cerebral palsy. Moreau, NG., Holthaus, K., Marlow, N.[2022]

In a study involving 22 children with spastic cerebral palsy, functional progressive resistance training (PRT) led to a significant increase in the thickness of the vastus lateralis muscle, indicating some positive effects on muscle morphology.

However, neither high-intensity circuit training (HICT) nor PRT resulted in significant changes in the gastrocnemius medialis or Achilles tendon properties, suggesting that more intense and longer training may be needed to achieve meaningful improvements in muscle and tendon function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Functional Home-Based Strength Training Programs on the Mechano-Morphological Properties of the Plantar Flexor Muscle-Tendon Unit in Children With Spastic Cerebral Palsy. Kruse, A., Schranz, C., Svehlik, M., et al.[2019]

A meta-analysis of 13 trials involving 412 children with cerebral palsy found that intensive exercise-based therapy did not significantly improve gross motor function compared to standard care, as measured by GMFM scores.

However, the study indicated that increasing the number of daily training hours and the duration of the exercise program positively correlated with improvements in gross motor function, suggesting that higher intensity and longer interventions may enhance outcomes for children with CP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Therapeutic Exercise Intensity on Cerebral Palsy Outcomes: A Systematic Review With Meta-Regression of Randomized Clinical Trials. Hsu, CW., Kang, YN., Tseng, SH.[2023]

A 3-month physical therapy program combining functional training and progressive resistance exercise led to significant improvements in lower extremity strength for an adolescent with cerebral palsy.

While improvements in functional strength, agility, and anaerobic power were clinically insignificant, the patient reported enhanced participation in activities and achieved new functional movements, highlighting the importance of personalized goals in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional movement, strength, and intervention for an adolescent with cerebral palsy. Hedgecock, JB., Rapport, MJ., Sutphin, AR.[2015]

Individualized progressive resistance training significantly increased muscle strength by 27% in young people with spastic diplegic cerebral palsy over 12 weeks, indicating that this type of training can effectively enhance physical capabilities.

Although participants reported improvements in mobility, these subjective benefits did not translate into measurable changes in objective mobility tests, suggesting that strength gains alone may not directly improve walking performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Progressive resistance training and mobility-related function in young people with cerebral palsy: a randomized controlled trial. Taylor, NF., Dodd, KJ., Baker, RJ., et al.[2015]

A 12-week program of explosive and progressive resistance training significantly increased the rate of force development in ankle dorsiflexors among 35 adults with cerebral palsy, suggesting improved muscle function.

The training also enhanced gait function, evidenced by increased toe lift and a more dorsiflexed ankle position during walking, indicating that explosive resistance training could be beneficial for improving mobility in adults with cerebral palsy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Explosive Resistance Training Increases Rate of Force Development in Ankle Dorsiflexors and Gait Function in Adults With Cerebral Palsy. Kirk, H., Geertsen, SS., Lorentzen, J., et al.[2018]

Goal-directed group circuit progressive resistance exercise training (GT) significantly improved motor function in adolescents with cerebral palsy compared to treadmill training (TT), with notable advantages in various functional measures after 30 bi-weekly sessions.

Both training methods were effective, but the GT group showed greater improvements in key assessments like GMFM-66 and TUG, although the differences were less pronounced at the 6-month follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a group circuit progressive resistance training program compared with a treadmill training program for adolescents with cerebral palsy. Aviram, R., Harries, N., Namourah, I., et al.[2018]

Intensive, goal-directed physiotherapy for three hours a day, five days a week over three weeks significantly improved motor function in children with cerebral palsy, as measured by the Gross Motor Function Measure-66 (GMFM-66), with a mean change of 4.5 points (p < 0.01).

Children classified at GMFCS levels I-II showed greater improvements compared to those at levels III-V, indicating that the therapy was more effective for children with milder impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Change in basic motor abilities, quality of movement and everyday activities following intensive, goal-directed, activity-focused physiotherapy in a group setting for children with cerebral palsy. Sorsdahl, AB., Moe-Nilssen, R., Kaale, HK., et al.[2022]

An eight-week training program significantly increased the physical work capacity (PWC) of seven ambulatory individuals with cerebral palsy, as measured by exercise tests.

The training also improved the ability of these individuals to perform simulated tasks, allowing them to work for eight hours before feeling fatigued, indicating a positive impact on their endurance and overall physical performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training of ambulatory individuals with cerebral palsy. Fernandez, JE., Pitetti, KH.[2019]

A study involving 14 children with spastic diplegia showed that a 6-week strength training program significantly increased quadriceps muscle strength, demonstrating the efficacy of heavy resistance exercise in this population.

The strength training not only improved muscle strength but also positively influenced gait, leading to better stride length and reduced crouch during walking, suggesting that resistance exercise should be included in treatment plans for children with cerebral palsy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of quadriceps femoris muscle strengthening on crouch gait in children with spastic diplegia. Damiano, DL., Kelly, LE., Vaughn, CL.[2019]

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