Cycle ergometer in the improvement of gross motor function of children with cerebral palsy
a systematic review with meta-analysis
DOI:
https://doi.org/10.1590/1809-2950/18011026012019Keywords:
Exercise, Cerebral Palsy, Randomized Controlled TrialAbstract
Cerebral palsy is a group of neurological disorders that causes innumerable deficits, mainly related to motor function, compromising movements and their selective control. Among the various therapies available to try to soften this process, the cycle ergometer appears as a stationary apparatus that aims to facilitate the movement of the lower limbs. Therefore, this study aimed to analyze the effects of the cycle ergometer on the gross motor function of children with cerebral palsy by the Gross Motor Function Measure (GMFM-66) scale. This was a systematic review, with inclusion of randomized clinical trials published until July 2017. The search was performed in MEDLINE (PubMed), Physiotherapy Evidence Database (PEDro), SciELO, and Embase. The Cochrane Handbook Scale was used to evaluate the methodological quality of the investigations. We selected articles that applied the cycle ergometer in children with cerebral palsy, compared to children with cerebral palsy in the control group or other intervention, and that assessed gross motor function with GMFM. The review included three articles and a total of 127 patients. The results have shown a not statistically significant increase in GMFM-66 values, not relevant for clinical improvement. This systematic review has found great heterogeneity in the studies addressing this area and, despite the increase in values in the group that used the cycle ergometer, there was no statistical difference compared to the control group, showing that it does not benefit the gross motor function of this population, when evaluated by GMFM-66.
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References
Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet.
;383(9924):1240-9. doi: 10.1016/S0140-6736(13)61835-8
Guimarães CL, Pizzolatto TO, Coelho AS, Freitas ST. Aspectos
clínicos epidemiológicos de crianças com paralisia cerebral
assistidas pela clínica escola de Fisioterapia Unip – São José
dos Campos. J Health Sci Inst. 2014;32(3):281-5.
Trønnes H, Wilcox AJ, Lie RT, Markestad T, Moster D. Riskof
cerebral palsy in relation to pregnancy disorders and
preterm birth: a national cohort study. Dev Med Child Neurol.
;56(8):779-85. doi: 10.1111/dmcn.12430
Reddihough, DS, Collins, KJ. The epidemiology and causes of
cerebral palsy. Aust J Physiother. 2003;49(1):7-12. doi: 10.1016/
S0004-9514(14)60183-5
Nooijen C, Slaman J, van der Slot W, Stam H, Roebroeck
M, van den Berg-Emons R, et al. Health-related physical
fitness of ambulatory adolescents and young adults with
spastic cerebral palsy. J Rehabil Med. 2014;46 (7):642-7. doi:
2340/16501977-1821
Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M,
Damiano D, et al. A report: the definition and classification
of cerebral palsy April 2006. Dev Med Child Neurol Suppl.
;109:8-14. doi: 10.1111/j.1469-8749.2007.tb12610.x
García CC, Alcocer-Gamboa A, Ruiz MP, Caballero
IM, Faigenbaum AD, Esteve-Lanao J, et al. Metabolic,
cardiorespiratory, and neuromuscular fitness performance in
children with cerebral palsy: a comparison with healthy youth.
J Exerc Rehabil. 2016;12(2):124-31. doi: 10.12965/jer.1632552.276
Santos LJ, Aguiar Lemos F, Bianchi T, Sachetti A, Dall’Acqua
AM, Naue WS, et al. Early rehabilitation using a passive
cycleergometer on muscle morphology in mechanically
ventilated critically ill patients in the Intensive Care Unit (MoVeICU study): study protocol for a randomized controlled trial.
Trials. 2015;16:383. doi: 10.1186/s13063-015-0914-8
Williams H, Pountney T. Effects of a static bicycleing programme
on the functional ability of young people with cerebral palsy
who are non-ambulant. Dev Med Child Neurol. 2007;49(7):522-
doi: 10.1111/j.1469-8749.2007.00522.x
Sandberg K, Kleist M, Falk L, Enthoven P. Effects of twice-weekly
intense aerobic exercise in early subacute stroke: a randomized
controlled trial. Arch Phys Med Rehabil.2016;97(8):1244-53.
doi: 10.1016/j.apmr.2016.01.030
Harvey AR. The Gross Motor FunctionMeasure (GMFM). J
Physiother. 2017;63(3):187-91. doi: 10.1016/j.jphys.2017.05.007
Alotaibi M, Long T, Kennedy E, Bavishi S. The efficacy of GMFM88 and GMFM-66 to detect changes in gross motor function
in children with cerebral palsy (CP): a literature review. Disabil
Rehabil. 2014;36(8):617-27. doi: 10.3109/09638288.2013.805820
Almeida KM, Albuquerque KA, Ferreira ML, Aguiar SKB, Mancini
MC. Reliability of the Brazilian Portuguese version of the Gross
Motor Function Measure in children with cerebral palsy. Braz
J Phys Ther. 2016;20(1):73-80. doi: 10.1590/bjpt-rbf.2014.0131
Palisano RJ, Rosenbaum P, Barlett D, Livingston MH.
Content validity of the expanded and revised Gross Motor
Function Classification System. Dev Med Child Neurol.
;50(10):744-50. doi: 10.1111/j.1469-8749.2008.03089.x
Carvalho APV, Silva V, Grande AJ. Avaliação do risco de viés de
ensaios clínicos randomizados pela ferramenta da colaboração
Cochrane. Diagn Tratamento. 2013;18(1):38-44.
Chen CL, Chen CY, Liaw MY, Chung CY, Wang CJ, Hong
WH. Efficacy of home-based virtual cycling training on
bone mineral density in ambulatory children with cerebral
palsy. Osteoporos Int. 2013;24(4):1399-406. doi: 10.1007/
s00198-012-2137-0.
Bryant E, Pountney T, Williams H, Edelman N. Can a sixweek exercise intervention improve gross motor function
for non-ambulant children with cerebral palsy? A pilot
randomized controlled trial. Clin Rehabil. 2013;27(2):150-9.
doi: 10.1177/0269215512453061
Fowler EG, Knutson LM, Demuth SK, Siebert KL, Simms VD, Sugi
MH, et al. Pediatric endurance and limb strengthening (PEDALS)
for children with cerebral palsy using stationary cycling: a
randomized controlled trial. Phys Ther. 2010;90(3):367-81. doi:
2522/ptj.20080364
Wang HY, Yang YH. Evaluating the responsiveness of 2 versions
of the gross motor function measure for children with cerebral
palsy. Arch Phys Med Rehabil. 2006;87(1):51-6. doi: 10.1016/j.
apmr.2005.08.117
Bartlett DJ, Palisano RJ. A multivariate model of determinants
of motor change for children with cerebral palsy. Phys Ther.
;80(6):598-614. doi: 10.1093/ptj/80.6.598
Chen CL, Lin KC, Wu CY, Ke JY, Wang CJ, Chen CY. Relationships
of muscle strength and bone mineral density in ambulatory
children with cerebral palsy. Osteoporos Int. 2012;23(2):715-21.
doi:10.1007/s00198-011-1581-6
Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano
RJ. Improved scaling of the Gross Motor Function Measure for
children with cerebral palsy: evidence of reliability and validity.
Phys Ther. 2000;80(9):873-85. doi: 10.1093/ptj/80.9.873
Dodd KJ, Taylor NF, Graham HK. A randomized clinical trial of
strength training in young people with cerebral palsy. Dev Med
Child Neurol.2003;45(10):652-7. doi: 10.1017/S0012162203001221
Taylor NF, Dodd KJ, Baker RJ, Willoughby K, Thomason P,
Graham HK. Progressive resistance training and mobility related
function in young people with cerebral palsy: a randomized
controlled trial. Dev Med Child Neurol. 2013;55(9):806-12. doi:
1111/dmcn.12190
Ryan JM, Cassidy EE, Noorduyn SG, O’Connell NE. Exercise
interventions for cerebral palsy. Cochrane Database Syst Rev.
;6:CD011660. doi: 10.1002/14651858.CD011660.pub2
Verschuren O, Ada L, Maltais DB, Gorter JW, Scianni A, Ketelaar
M. Muscle strengthening in children and adolescents with
spastic cerebral palsy: considerations and future resistance
training protocols. Phys Ther. 2011;91(7):1130-9. doi: 10.2522/
ptj.20100356
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