Dissertation: The EXECP project - a neuromechanical examination of hyper-resistance within an exercise intervention for children and young adults with cerebral palsy
Spastic cerebral palsy and exercise
Cerebral palsy is a neurodevelopmental condition caused by a lesion in the developing fetal or infant brain. During development, the lesion leads to secondary symptoms such as muscle weakness, reduced joint flexibility and incoordination, which hinder motor function for everyday tasks such as walking and climbing stairs. These secondary symptoms lead to a decrease in physical activity and cardiovascular performance, increasing the risk of chronic diseases such as cardiovascular problems. Thus, therapeutic interventions capable of breaking this downward spiral of inactivity and loss of function are of upmost importance. The primary aim of this thesis was to create the EXECP intervention to address these secondary symptoms and verify if it was capable of increasing motor function in children and young adults with spastic CP.
Motor function can be improved without adverse effects
The EXECP intervention was successful in increasing motor function in everyday tasks such as climbing stairs and walking, without any adverse side effects. Muscle strength was enhanced in the thigh and trunk muscles, but no changes in the shank muscles were found. Since motor control of distal muscles is worse in CP, it seems that the training load used in the intervention was insufficient to enhance muscle strength in the ankle plantarflexors and dorsiflexors. Joint flexibility also had a statistically significant increase; however, the magnitude of change was small and possibly functionally insignificant. It is unclear if the enhanced flexibility was due to changes in the tolerance to stretch and/or muscle-tendon structural adaptations.
Detraining effects
Participants with CP were re-assessed three months after the EXECP intervention ceased. Except for the walking distance in the six minutes walking test and knee flexors flexibility, all other adaptations induced by the intervention regressed back towards pre-intervention levels. This result was expected. In fact, a physical training principle called the “reversibility principle” states that adaptations in the physical capacities are lost with time once the training stimulus ceases. The present results shows that three months were enough for detraining, suggesting that people with CP should adopt an active lifestyle in which training is part of their everyday life.
Pedro Valadão, MSc, defends his doctoral dissertation, “The EXECP project: a neuromechanical examination of hyper-resistance within an exercise intervention for children and young adults with cerebral palsy”, on 08 March 2024 at 12:00 in L304. The opponent is Professor Jean-Michel Gracies (University of Paris-Est Créteil, France) and Custos Professor Taija Juutinen Finni (Ģֱ). The doctoral dissertation defence will be held in English.
The doctoral defense is held in English, and it is possible to follow it live .
More information:
Pedro Valadão, pedro.valadao@jyu.fi
