Efficacy of upper limb strengthening in children with Cerebral Palsy: A critical review

OBJECTIVE: This review focuses on the effects of strengthening interventions of the upper limb in children with Cerebral Palsy (CP). The strengthening intervention studies were divided in two categories: those based on stand-alone strength training, and those on strength training combined with other interventions. DATA SOURCES AND EXTRACTION: A search in all relevant databases was performed. DATA SYNTHESIS: Six articles were included: three randomized controlled trials (RCTs), two clinical trial (CT) and one case study. Effect sizes of strength training on muscle strength and function of the upper limb were calculated. CONCLUSION: There are no coherent recommendations for strength training, based on these studies. The causes include too much variety of types of training, level of intensity and duration. All of the reported upper limb strength training studies found an increase in muscle strength. In addition, the quality of these studies was not high. More RCTs on strength training according to the official strength training guidelines are necessary to assess the impact and potential of strength training of the upper limb to improve the daily activities and participation in children with CP.