Clinical Bottom Line
“How could I apply this information?”
Assessment of anaerobic performance in children with spastic cerebral palsy (CP), Gross Motor Function Classification System (GMFCS) levels I and II, may be feasible in the clinical setting using the Muscle Power Sprint Test. Based on the authors' findings, assessing anaerobic function may eventually lead to more directed interventions to improve anaerobic capacity. The Gross Motor Function Measure is commonly used to evaluate children with CP, although this measure focuses on activities requiring lower energy output. The Muscle Power Sprint Test may help expand current assessment tests and measures, particularly when evaluating children who are often integrated into physical education and sports with peers with typical development (TD).
“What should I be mindful about when applying this information?”
Children with CP in comparison with children with TD had decreased muscle power as measured by the MSPT. However, greater height was associated with higher power in all 3 groups of children (those at GMFCS levels I and II, and those with TD). The rate of increasing height with increasing power was greater for children with spastic CP GMFCS level I in comparison with children with TD, but this rate of change was lower for children with spastic CP GMFCS level II in comparison with children with TD. However, a longitudinal design, and a wider array of outcomes using the International Classification of Functioning, Disability and Health Model (ICF), would further strengthen these results to more comprehensively inform and strengthen treatment interventions. In evaluating and treating a child with CP, one must consider impairments related to abnormal tone, neurological involvement, and decreased strength, balance, motor control, and coordination, especially when incorporating velocity or power training. Furthermore, one should assess how improvement in anaerobic capacity may ultimately translate into improved participation, function, and quality of life. Additional complementary measures of the participation component of the ICF model may better represent how interventions aimed at anaerobic performance relate to meaningful change in the child's life.
Jeremy Wong, DPT
Susan Knight, PT, PCS
Children's Hospital Los Angeles
Los Angeles, California