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This Article Full Text Full Text (PDF) Discussion Podcast All Versions of this Article: ptj.20080364v1 90/3/367    most recent Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Fowler, E. G. PubMed PubMed Citation Articles by Fowler, E. G. Related Collections Therapeutic Exercise Cerebral Palsy Cerebral Palsy (Pediatrics) Randomized Controlled Trials Social Bookmarking                      What's this?

Pediatric Endurance and Limb Strengthening (PEDALS) for Children With Cerebral Palsy Using Stationary Cycling: A Randomized Controlled Trial

E.G. Fowler, PT, PhD, is Associate Professor, Department of Orthopaedic Surgery, Director of Research and Education and Peter William Shapiro Chair, UCLA/Orthopaedic Hospital Center for Cerebral Palsy, University of California at Los Angeles, and Faculty, Tarjan Center at UCLA, 22-70 Rehabilitation Center, 1000 Veteran Ave, Los Angeles, CA 90095-1795 (USA).
L.M. Knutson, PT, PhD, PCS, is Adjunct Faculty, Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, Indiana. She was Professor, Department of Physical Therapy, Missouri State University, Springfield, Missouri, at the time this study was conducted.
S.K. DeMuth, PT, DPT, MS, is Assistant Professor of Clinical Physical Therapy, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, Los Angeles, California.
K.L Siebert, PT, DPT, MEd, is Staff Physical Therapist and Clinical Instructor, South Bay Medical Therapy Unit, California Children's Services of Los Angeles County. She was Postdoctoral Fellow, Department of Orthopaedic Surgery, UCLA/Orthopaedic Hospital Center for Cerebral Palsy, University of California at Los Angeles, at the time this study was conducted.
V.D. Simms, PT, MPT, was Research Assistant, Department of Physical Therapy, Missouri State University, at the time this study was conducted.
M.H. Sugi, PT, DPT, is Staff Physical Therapist, Hollywood Presbyterian Medical Center, Los Angeles, California, and Staff Physical Therapist, Every Child Achieves, Studio City, California. She was Postdoctoral Fellow, Department of Orthopaedic Surgery, UCLA/Orthopaedic Hospital Center for Cerebral Palsy, University of California at Los Angeles, at the time this study was conducted.
R.B. Souza, PT, PhD, is Postdoctoral Scholar in Radiology and Biomedical Imaging, University of California, San Francisco, California. He was a doctoral student in the Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, at the time the study was conducted.
R. Karim, MBBS, PhD, is Assistant Professor of Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California.
S.P. Azen, PhD, is Professor, Department of Preventive Medicine, Keck School of Medicine, University of Southern California.
Physical Therapy Clinical Research Network (PTClinResNet) (see list of investigators in the Footnotes section).

Address all correspondence to Dr Fowler at: efowler{at}mednet.ucla.edu.

Background: Effective interventions to improve and maintain strength (force-generating capacity) and endurance are needed for children with cerebral palsy (CP).

Objective: This study was performed to examine the effects of a stationary cycling intervention on muscle strength, locomotor endurance, preferred walking speed, and gross motor function in children with spastic diplegic CP.

Design: This was a phase I randomized controlled trial with single blinding.

Setting: The interventions were performed in community-based outpatient physical therapy clinics. Outcome assessments were performed in university laboratories.

Participants: Sixty-two ambulatory children aged 7 to 18 years with spastic diplegic CP and Gross Motor Function Classification System levels I to III participated in this study.

Intervention and Measurements: Participants were randomly assigned to cycling or control (no-intervention) groups. Thirty intervention sessions occurred over 12 weeks. Primary outcomes were peak knee extensor and flexor moments, the 600-Yard Walk-Run Test, the Thirty-Second Walk Test, and the Gross Motor Function Measure sections D and E (GMFM-66).

Results: Significant baseline-postintervention improvements were found for the 600-Yard Walk-Run Test, the GMFM-66, peak knee extensor moments at 120°/s, and peak knee flexor moments at 30°/s for the cycling group. Improved peak knee flexor moments at 120°/s were found for the control group only, although not all participants could complete this speed of testing. Significant differences between the cycling and control groups based on change scores were not found for any outcomes.

Limitations: Heterogeneity of the patient population and intrasubject variability were limitations of the study.

Conclusions: Significant improvements in locomotor endurance, gross motor function, and some measures of strength were found for the cycling group but not the control group, providing preliminary support for this intervention. As statistical differences were not found in baseline-postintervention change scores between the 2 groups; the results did not demonstrate that stationary cycling was more effective than no intervention. The results of this phase I study provide guidance for future research.

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