Safety and Feasibility of 1-Repetition Maximum (1-RM) Testing in Children and Adolescents With Bilateral Spastic Cerebral Palsy.

This was a descriptive safety and feasibility study, not a randomized trial of resistance training or a test of whether 1-repetition maximum testing improves walking, strength training outcomes, or daily function. The sample included only bilateral spastic cerebral palsy, ages 10-17 years, and GMFCS levels I-III. It excluded recent orthopedic or neurosurgery within the last year, botulinum toxin in the last 3 months, and knee flexion contractures greater than 25 degrees. The sample was small: 24 participants, with only 2 at GMFCS level I and 3 at GMFCS level III, so group differences and strength averages are unstable. The protocol used one horizontal leg press device at a fixed 29.4-degree angle. Loads and feasibility may not transfer to other machines, free weights, squats, or other testing modes. A single test took 30-45 minutes and could consume an entire physical therapy session. The leg press required gripping a handle bar, which may be difficult for people with upper extremity weakness. Some participants needed weight lifting hooks, and upper extremity maximal strength testing was not evaluated. Safety findings are based on 24 participants and one mild adverse event, so rare or serious injuries cannot be ruled out.

The supplied publication types indicate research support from N.I.H., Extramural. The provided text does not include a conflicts-of-interest declaration or state who designed the study or wrote the manuscript.

Do not conclude that 1-repetition maximum testing improves walking, muscle strength gains, or resistance training results. This study only tested whether the leg press 1-repetition maximum procedure was safe and feasible in 24 children and adolescents with bilateral spastic cerebral palsy.