Progressive resistance exercise for adults with athetoid cerebral palsy: a single subject research design

Objective: To find out if a progressive resistance exercise (PRE) program improved the muscle strength and the physical activity of adults with athetoid cerebral palsy. Design: A single-subject AB research design Setting: A community gymnasium Subjects: Two men and two women over 40 years (mean 46.0 years, SD 6.4, range 40-55) with athetoid quadriplegic cerebral palsy and high support needs. Interventions: Participants attended the gymnasium once a week for four weeks for familiarization, and then completed a 10-week PRE program conducted twice a week, consisting of exercises designed to increase the maximum amount of force that could be generated by the muscles of the upper and lower limbs. Measurements: Weekly measurements were made of upper and lower limb maximum muscle force (strength), represented by the amount of weight that could be lifted once in a seated chest press and leg press (1RM), and functional activity by timed sit-to-stand. Results: Analysis by the C-statistic, the Reliable Change Score Index and visual analysis suggested that participant 2 improved in all three outcomes. Participant 3 improved upper limb strength, Participant 4 improved lower limb strength, while no change was detected in any outcome for Participant 1. Conclusions: This study provides preliminary evidence that PRE can be beneficial for some adults with athetoid cerebral palsy. Although the results did not lead to positive benefits for all participants, no negative effects were detected. Single-subject research design might be a useful method for clinicians to evaluate individual changes in clients.