The effect of quadriceps femoris muscle strengthening exercises on spasticity in children with cerebral palsy

Background and Purpose. The Bobath neurodevelopmental treatment approach ad vised against the use of resistive exercise, as proponents felt that increa sed effort would increase spasticity. The purpose of this study was to test the premise that the performance of exercises with maximum efforts will in crease spasticity in people with cerebral palsy (CP). Spasticity, in the pr esent study, was defined as a velocity-dependent hyperexcitability of the m uscle stretch reflex. Subjects. Twenty-four subjects with the spastic diple gic form of CP (mean age = 11.4 years, SD = 3.0, range = 7-17) and 12 subje cts without known neurological impairments (mean age = 11.6 years, SD = 3.5 , range 7-17) were assessed. Methods. Knee muscle spasticity was assessed b ilaterally using the pendulum test to elicit a stretch reflex immediately b efore and after 3 different forms of right quadriceps femoris muscle exerci se (isometric, isotonic, and isokinetic) during a single bout of exercise t raining. Pendulum test outcome measures were: (I) first swing excursion, (2 ) number of lower leg oscillations, and (3) duration of the oscillations. R esults. There were no changes in spasticity following exercise between the 2 groups of subjects. Discussion and Conclusion. These results do not suppo rt the premise that exercises with maximum efforts increase spasticity in p eople with CP.