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Explosive Resistance Training Increases Rate of Force Development in Ankle Dorsiflexors and Gait Function in Adults With Cerebral Palsy

Kirk, Henrik; Geertsen, Svend S.; Lorentzen, Jakob; Krarup, Kasper B.; Bandholm, Thomas; Nielsen, Jens B.

Journal of Strength and Conditioning Research: October 2016 - Volume 30 - Issue 10 - p 2749–2760
doi: 10.1519/JSC.0000000000001376
Original Research

Kirk, H, Geertsen, SS, Lorentzen, J, Krarup, KB, Bandholm, T, and Nielsen, JB. Explosive resistance training increases rate of force development in ankle dorsiflexors and gait function in adults with cerebral palsy. J Strength Cond Res 30(10): 2749–2760, 2016—Alterations in passive elastic properties of muscles and reduced ability to quickly generate muscle force contribute to impaired gait function in adults with cerebral palsy (CP). In this study, we investigated whether 12 weeks of explosive and progressive heavy-resistance training (PRT) increases rate of force development of ankle dorsiflexors (RFDdf), improves gait function, and affects passive ankle joint stiffness in adults with CP. Thirty-five adults (age: 36.5; range: 18–59 years) with CP were nonrandomly assigned to a PRT or nontraining control (CON) group in this explorative trial. The PRT group trained ankle dorsiflexion, plantarflexion, leg press, hamstring curls, abdominal curls, and back extension 3 days per week for 12 weeks, with 3 sets per exercise and progressing during the training period from 12 to 6 repetition maximums. RFDdf, 3-dimensional gait analysis, functional performance, and ankle joint passive and reflex-mediated muscle stiffness were evaluated before and after. RFDdf increased significantly after PRT compared to CON. PRT also caused a significant increase in toe lift late in swing and a significantly more dorsiflexed ankle joint at ground contact and during stance. The increased toe-lift amplitude was correlated to the increased RFDdf (r = 0.73). No other between-group differences were observed. These findings suggest that explosive PRT may increase RFDdf and facilitate larger range of movement in the ankle joint during gait. Explosive PRT should be tested in clinical practice as part of a long-term training program for adults with CP.

1Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark;

2Helene Elsass Center, Charlottenlund, Denmark;

3Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark; and

4Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical Therapy, Department of Orthopedic Surgery, Clinical Research Centre, Hvidovre Hospital, University of Copenhagen, Denmark

Address correspondence to Henrik Kirk,

H. Kirk and S. S. Geertsen author contributed equally.

Copyright © 2016 by the National Strength & Conditioning Association.