The Impact of Functional Strength Training on Muscle Strength and Mobility in Children with Spastic Cerebral Palsy–A Systematic Review and Meta-Analysis

Objective: To review the effects of functional strength training (FST) on muscle strength and mobility in children with spastic cerebral palsy (CP). Methods: Eight databases were screened through March 2022 for studies assessing the impact of FST on strength, mobility, balance, and endurance in children with spastic CP. Study quality was assessed using the Downs and Black checklist and Cochrane Risk of Bias tools, followed by a meta-analysis. Results: Twelve intervention studies of moderate-to-high-level evidence were selected. The interventions included open and closed chain exercises using free weights or body weight, administered approximately thrice a week for 12 weeks. The FST was found to have a moderate-to-large, statistically significant, positive effect on muscle strength (quadriceps, hamstrings, and plantar flexors) and mobility (GMFM D and E), with only four studies showing maintenance of gains during follow-up assessment. Conclusion: FST has a positive effect on muscle strength and mobility in children with spastic CP, but evidence of sustained effects following FST is limited.