Presentation Abstract

Muscle Size Matters in Cerebral Palsy (CP)

Cerebral Palsy (CP) is the most prevalent neuromotor disability originating in childhood and affecting many aspects of health and functioning across the lifespan. While the basic rationale for strengthening in CP is similar to other rehabilitation populations, two challenges in particular are unique. First, limited and/or abnormal motor activity starts early in life with major effects on development of the neuromotor and musculoskeletal systems. Second, the motor disability, which can range from mild and limited to a few joints to profound whole-body involvement, constrains exercise capabilities. The motor disorder in CP originates in the brain but has complex secondary effects on the muscles and many current treatments further exacerbate weakness. Many with CP face “premature aging” including accelerated loss of mobility and cardiorespiratory health issues at much younger ages than the general population. Greater development, promotion and implementation of effective lifespan strategies to maintain strength are an inadequately met need. Research evidence on strengthening for non-ambulatory individuals with CP is notably lacking even though they are at highest risk for adverse health and functioning outcomes and present the greatest challenges for the design of effective and safe physical training. Novel technological solutions such as motor-assisted exercise devices, robotic exoskeletons, multichannel electrical stimulation and brain machine interfaces to help control, assist and/or train movement capabilities are emerging and may offer more effective methods beyond physical training alone to improve and maintain muscle strength in CP.  

About Dr. Damiano

Diane L. Damiano is a Senior Investigator at the NIH in Bethesda, Maryland and Chief of the Functional and Applied Biomechanics Section in the Rehabilitation Medicine Department. Her early research challenged the clinical belief that strength training was not appropriate for those with spasticity. Dr. Damiano’s current research focuses on the design and investigation of activity-based rehabilitation programs and devices to promote optimal motor functioning and enhance muscle and neural plasticity in CP. She serves as an Associate Editor for Neurorehabilitation and Neural Repair and has served as President of the American Academy for Cerebral Palsy and Developmental Medicine and the Gait and Clinical Movement Analysis Society.

Dr. Damiano did not disclose any conflicts of interest for this workshop.