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Effects of Strengthening Exercise on Gait Ability and GMFM in Cerebral Palsy : A Systematic Review and Meta-Analysis
J Korean Soc Phys Med 2018;13(3):39-47
Published online August 31, 2018;
© 2018 Journal of The Korean Society of Physical Medicine.

Seong-Gyeong Heo, PT⋅Han-Suk Lee, PT, Ph.D1† ⋅Sun-Wook Park, PT, Ph.D2

Department of Physical Therapy, Seonam Welfare Center for the Disabled
1Department of Physical Therapy, Eulji University
2Department of Physical Therapy, Samsung Medical Center
Received June 18, 2018; Revised June 21, 2018; Accepted July 27, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
PURPOSE: The purpose of this investigation was to conduct a systemic review of studies that examine the effects of strengthening exercise on gait ability and GMFM in children with cerebral palsy and propose a standard for cerebral palsy therapy based on a meta-analysis of the studies.
METHODS: An extensive literature search was conducted using databases including the KISS (Korean studies Information Service System), RISS, DBpia, PubMed and ScienceDirect, with the following search terms: ‘Strengthening Exercise,’ ‘Resistance Exercise,’ ‘Gait ability,’ ‘GMFM’ or ‘cerebral palsy’.
RESULTS: Eleven studies were included in this review and the duration of the intervention varied from 5 to 24 weeks. The number of application per week was mostly 2-3 times, while 5 intervention per week was adopted in a few cases. The total number of intervention applied varied from 18 to 36 and the respective effect sizes of GMFM on crawling and sitting were very high (1.075 and .881) while those of GMFM on standing and walking were very low(.206 and .125). The effect size was for gait speed was only .221.
CONCLUSION: Trunk exercise and lower limb exercise effectively improved GMFM in children with cerebral palsy, resulting in improved outcomes in sitting and crawling. The results of this study will be useful for designing evidencebased cerebral palsy therapy programs.
Keywords : Cerebral palsy, Gait ability, GMFM, Resistance exercise, Strengthening exercise

August 2018, 13 (3)
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