Efficacy of home-based virtual cycling training on bone mineral density in ambulatory children with cerebral palsy.
The 12-week home-based virtual cycling training (hVCT) improved lower limb muscle strength and areal bone mineral density (aBMD) than the control program in children with cerebral palsy (CP). A muscle strengthening program, rather than general physical activity, is more specific in enhancing aBMD for these children. A novel hVCT is an effective and efficient strategy that enhances lower limb bone density in these children.


BACKGROUND
This is the first study to assess the efficacy of a novel hVCT program on bone density for children with spastic CP using a well-designed randomized controlled trial.


METHODS
Twenty-seven ambulatory children with spastic CP, aged 6-12 years, were randomly assigned to the hVCT group (n=13) or control group (n=14). Outcome measures-motor function [Gross Motor Function Measure-66 (GMFM-66)], muscle strength (curl up scores and isokinetic torque of knee extensor and flexor muscle) and aBMD of the lumbar and distal femur-were administered before and immediately after the 12-week intervention.


RESULTS
Analysis of covariance results show that the hVCT group had greater distal femur aBMD and isokinetic torques of knee extensor and flexor muscles than the control group at posttreatment (p<0.05). However, curl up scores, GMFM-66, and lumbar aBMD at posttreatment did not differ between the two groups.


CONCLUSIONS
Analytical findings suggest that the muscle strengthening program is more specific in enhancing bone density for children with CP than general physical activity. Thus, the proposed 12-week hVCT protocol is an effective and efficient strategy for improving lower limb aBMD in these children.
Physical Medicine and Rehabilitation, Chang Gung Memorial hospital, Linkou, and Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, 5 Fu-Hsing St. Kwei-Shan, Tao-Yuan, 333, Taiwan.
C-L
CL
Chen
C-Y
CY
Chen
M-Y
MY
Liaw
C-Y
CY
Chung
C-J
CJ
Wang
W-H
WH
Hong
D001642:Bicycling / Q000502:physiology*; D015519:Bone Density / Q000502:physiology*; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005269:Femur / Q000503:physiopathology; D006699:Home Care Services; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D063367:Virtual Reality Exposure Therapy / Q000379:methods*; D016138:Walking / Q000502:physiology