The Efficacy of Eight Weeks of Chair Training for Steps Width and Length in Adults with Cerebral Palsy Paraplegia

Document Type : Original Articles


1 MSc Student, Department of Sport Biomechanics, School of Physical Education and Sport Sciences, Shahid Bahonar University, Kerman, Iran

2 Assistant Professor, Department of Sport Biomechanics, School of Physical Education and Sport Sciences, Shahid Bahonar University, Kerman, Iran

3 Assistant Professor, Department of Sport Injury and Corrective Exercises, School of Physical Education and Sport Sciences, Shahid Bahonar University, Kerman, Iran

4 Assistant Professor, Department of Physiotherapy, School of Paramedicine, Kerman University of Medical Sciences, Kerman, Iran



Introduction: There are many negative factors in patients with cerebral palsy that cause these patients to deviate from normal walking patterns. The ability to walk is as one of the criteria for determining independence in daily activities of patients with cerebral palsy. Thus, the investigation of kinematic characteristics of walking (steps width and length, and velocity and frequency of stepping) has been considered by researchers. The aim of the present study was to investigate the effect of chair training on steps width and length in patients with cerebral palsy.Materials and Methods: 40 men and women with paraplegia were equally divided into 2 groups of control and experiment. Before and after 8 weeks of chair training, kinematic parameters of steps length and width were measured using three-dimensional motion analysis system (Motion Analysis). Mixed repeated measure ANOVA test at the significance level of P < 0.05 was used for data analysis.Results: The steps length and width improved after 8 weeks of chair training (P = 0.001). There were significant differences in steps length (P = 0.020) and steps width (P = 0.042) between the groups.Conclusion: It seems that 8 weeks of chair training can improve steps length and width among adults with paraplegia. Chair exercises can be used to increase steps length and decrease steps width during walking for adults with paraplegia.


  1. Rahimi-Movaghar V, Sayyah MK, Akbari H, Khorramirouz R, Rasouli MR, Moradi-Lakeh M, et al. Epidemiology of traumatic spinal cord injury in developing countries: A systematic review. Neuroepidemiology 2013; 41(2): 65-85.
  2. Postma K, van den Berg-Emons HJ, Bussmann JB, Sluis TA, Bergen MP, Stam HJ. Validity of the detection of wheelchair propulsion as measured with an Activity Monitor in patients with spinal cord injury. Spinal Cord 2005; 43(9): 550-7.
  3. de Groot S, Dallmeijer AJ, Bessems PJ, Lamberts ML, van der Woude LH, Janssen TW. Comparison of muscle strength, sprint power and aerobic capacity in adults with and without cerebral palsy. J Rehabil Med 2012; 44(11): 932-8.
  4. Eek MN, Tranberg R, Beckung E. Muscle strength and kinetic gait pattern in children with bilateral spastic CP. Gait Posture 2011; 33(3): 333-7.
  5. Carlberg EB, Hadders-Algra M. Postural dysfunction in children with cerebral palsy: some implications for therapeutic guidance. Neural Plast 2005; 12(2-3): 221-8.
  6. Burtner PA, Woollacott MH, Craft GL, Roncesvalles MN. The capacity to adapt to changing balance threats: a comparison of children with cerebral palsy and typically developing children. Dev Neurorehabil 2007; 10(3): 249-60.
  7. Prosser LA, Lee SC, VanSant AF, Barbe MF, Lauer RT. Trunk and hip muscle activation patterns are different during walking in young children with and without cerebral palsy. Phys Ther 2010; 90(7): 986-97.
  8. McDermott C, White K, Bushby K, Shaw P. Hereditary spastic paraparesis: A review of new developments. J Neurol Neurosurg Psychiatry 2000; 69(2): 150-60.
  9. Perry J, Burnfield JM. Gait analysis: Normal and pathological function. J Sports Sci Med 2010; 9(2): 353.
  10. Bunch W, Wenger DR. American Academy of Orthopaedic Surgeons' Atlas of Orthotics-Biomechanical Principles and Application. J Pediatr Orthop 1987; 7(1): 109.
  11. Traywick L, Vincent J, Washburn L, Copeland L. Deskercise – Sit, Stretch, Strengthen. Family and Consumer Sciences [Online]. [cited 2017]; Available from: URL:
  12. McBeath AA, Bahrke M, Balke B. Efficiency of assisted ambulation determined by oxygen consumption measurement. J Bone Joint Surg Am 1974; 56(5): 994-1000.
  13. A'sgari T, Hadian M R, Nakhostin-Ansari N, Abdolvahhab M, Jalili M, Faghih-Zadeh S. Berg Balance Scale reliability for evaluation in children with spastic diplegia. J Rehabil 2007; 8(2): 13-6. [In Persian].
  14. Winter DA. Biomechanics and motor control of human movement. 4th ed. Hoboken, NJ: John Wiley and Sons; 2009.
  15. Moreno CC, Mendes LA, Lindquist AR. Effects of treadmill inclination on the gait of individuals with chronic hemiparesis. Arch Phys Med Rehabil 2011; 92(10): 1675-80.
  16. Damiano DL, Vaughan CL, Abel MF. Muscle response to heavy resistance exercise in children with spastic cerebral palsy. Dev Med Child Neurol 1995; 37(8): 731-9.
  17. Blundell SW, Shepherd RB, Dean CM, Adams RD, Cahill BM. Functional strength training in cerebral palsy: A pilot study of a group circuit training class for children aged 4-8 years. Clin Rehabil 2003; 17(1): 48-57.
  18. Cargeeg A, Blackmore AM, Phillips S. Effects of circuit training for adolescents and young adults with spastic Diplegia [Thesis]. Bentley, Australia: Curtin University of Technology; 2008.
  19. Eagleton M, Iams A, McDowell J, Morrison R, Evans CL. The effects of strength training on gait in adolescents with cerebral palsy. Pediatr Phys Ther 2004; 16(1): 22-30.
  20. Unger M, Faure M, Frieg A. Strength training in adolescent learners with cerebral palsy: a randomized controlled trial. Clin Rehabil 2006; 20(6): 469-77.
  21. Wiley ME, Damiano DL. Lower-extremity strength profiles in spastic cerebral palsy. Dev Med Child Neurol 1998; 40(2): 100-7.
  22. Kisner C, Colby LA. Therapeutic exercise: Foundations and techniques. 5th ed. Philadelphia, PA: F.A. Davis Company; 2007.
  23. Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: The effect of using a cane. Arch Phys Med Rehabil 1999; 80(7): 777-84.
  24. Rose J, Wolff DR, Jones VK, Bloch DA, Oehlert JW, Gamble JG. Postural balance in children with cerebral palsy. Dev Med Child Neurol 2002; 44(1): 58-63.
  25. Teixeira-Salmela LF, Olney SJ, Nadeau S, Brouwer B. Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors. Arch Phys Med Rehabil 1999; 80(10): 1211-8.
  26. Ross SA, Engsberg JR. Relationships between spasticity, strength, gait, and the GMFM-66 in persons with spastic diplegia cerebral palsy. Arch Phys Med Rehabil 2007; 88(9): 1114-20.
  • Receive Date: 11 June 2017
  • Revise Date: 19 April 2024
  • Accept Date: 22 May 2022