Children with cerebral palsy (CP) often have leg weakness due to reduced muscle size. Researchers in the UK examined the effects of a 10 week training program of progressive strengthening of the plantar flexors in 13 children with spastic CP. The children began with Thera-Band-resisted plantar flexion in long-sitting and progressed to standing heel raises. They performed 3 to 4 sets of exercises at a 6-12 Repetition Maximum (RM) resistance with a 2-minute rest between sets. Once subjects were able to perform 6 calf raises, they continued that exercise until they could perform 12. Each session started and ended with calf stretches in standing. Exercises were performed 4 times per week, including 3 sessions at home.  After the 2 ½ month training program, muscle volume increased 14-17% and was maintained 3 months after training. Interestingly, while the participant’s strength increased, their functional measures did not.  The authors concluded that strengthening interventions may be one of the most important interventions in the short term for children with CP in order to support long-term functional gains.


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McNee AE, et al.. 2009 . Increases in muscle volume after plantarflexor strength training in children with spastic cerebral palsy . Dev Med Child Neurol: 51(6):429-35.

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