title: Impact of loaded sit-to-stand exercises at different speeds on the physiological cost of walking in children with spastic diplegia: A single-blind randomized clinical trial.
abstract: OBJECTIVE
  In the present study, we aimed to determine whether similarly loaded sit-to-stand exercises at different speeds improve the physiological cost of walking in children with spastic diplegia.
  
  
  METHODS
  This design was a single-blind randomized clinical trial. Sixteen children with cerebral palsy (CP), aged 12-18 years, with a diagnosis of spastic diplegia, were randomly allocated to a slow loaded sit-to-stand exercise group (n=8) and a self-paced loaded sit-to-stand exercise group (n=8). Loaded sit-to-stand exercise was conducted at home for 15min, 4 sets per day, 3-4days per week, for 6 weeks. The patients were evaluated immediately before the intervention and after the training. Lower limb muscle strength using a hand-held dynamometer, selective voluntary motor control using SCALE, 6-min walk distance (6MWD), and Physiological Cost Index (PCI) were measured.
  
  
  RESULTS
  The 6MWD showed a significant difference before and after intervention. PCI showed a significant difference between the two groups and the two time points. 6MWD and the PCI improved after intervention in the slow sit-to-stand exercise group.
  
  
  CONCLUSIONS
  Compared to loaded sit-to-stand exercise at a regular speed, slow low-loaded sit-to-stand exercise improved the 6MWD and PCI in children with CP, suggesting that this decrease in speed during exercise improves the physiological cost of walking in these children.
authors.affiliation: Department of Physical Therapy, Faculty of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ohta-ku, Tokyo, 144-8535, Japan. Electronic address: kusumotoys@stf.teu.ac.jp.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Kusumoto
authors.affiliation: Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Japan. Electronic address: nittaosm@hs.tmu.ac.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nitta
authors.affiliation: Department of Rehabilitation, Minamitama Orthopedic Hospital, Japan. Electronic address: takaki1105jp@yahoo.co.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takaki
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D053580:Muscle Strength; D010807:Physical Endurance; D026741:Physical Therapy Modalities; D011187:Posture; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method; D000070857:Walk Test; D016138:Walking
keywords: Cerebral palsy; Home rehabilitation; Loaded sit-to-stand exercises; Physiological cost; Speed