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Strength Training Can Have Unexpected Effects on the Self-Concept of Children with Cerebral Palsy

Dodd, Karen J. PhD; Taylor, Nicholas F. PhD; Graham, H. Kerr MD, FRCS(Ed), FRACS

Pediatric Physical Therapy: July 2004 - Volume 16 - Issue 2 - p 99-105
doi: 10.1097/01.PEP.0000127566.90996.50
Research Report

Purpose: This study was designed to evaluate the effect of a home-based progressive resistance strength-training program on the self-concept of children with cerebral palsy.

Methods: A randomized, controlled trial was used to evaluate the effects of a six-week strength-training program on self-concept immediately after completion of the program (week six) and at a follow-up session held 18 weeks after the initial assessment. Seventeen children [eight boys, nine girls; mean age 12.1 years (SD 2.5)] with spastic diplegic cerebral palsy were recruited. Participants in the experimental group completed a home-based progressive resistance strength-training program using three exercises to strengthen the major support muscles of the lower limb. Participants in the control group undertook their normal daily activities. Self-concept was measured by the Self-Perception Profile for Children.

Results: Overall, the self-concept of both groups was positive at baseline and at six and 18 weeks. However, compared with controls, the experimental group showed decreased self-concept in the domain of scholastic competence and a trend for a decrease in social acceptance at six weeks. At follow-up, the experimental group had reduced self-concept in the domains of scholastic competence and social acceptance compared with the control group.

Conclusion: These unexpected results suggest that participation in a relatively short home-based strength-training program may have an inhibitory effect on the self-concept of children with cerebral palsy. Despite the inhibitory effect, self-concept in the experimental group remained positive after strength training, suggesting that clinicians should not be overly concerned about the psychological effects of the intervention.

This controlled clinical trial involving strength training for children with CP resulted in an unexpected inhibitory effect on children’s self concept. Because self concept was strong at the start of the study, the authors continue to recommend strengthening programs for children with CP.

Musculoskeletal Research Centre, School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Victoria, Australia (K.J.D., N.F.T.); and Orthopaedic Surgery, University of Melbourne, and Hugh Williamson Gait Laboratory, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia (H.K.G.)

Address correspondence to: Karen J. Dodd, PhD, School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Victoria, 3086 Australia. Email:

Grant support: This study was supported by a La Trobe University Faculty of Health Sciences Research Grant (grant no. A12/2001).

© 2004 Lippincott Williams & Wilkins, Inc.