Objective: Objective determination of motor functions, energy expenditures, muscle weakness, and clinical effectiveness of rehabilitation program in ambulatory spastic cerebral palsy.

Materials and Methods: Sixteen ambulatory spastic diplegic cerebral palsy (CP) patients aged between 6-14 years were recruited to study. Measurement of gross motor function measure (GMFM), energy expenditure index (EEI), and concentric strength of knee extensor and flexor muscle groups for both extremities were performed before and after rehabilitation program. Statistical analyses were performed to determine the significance of changes in GMFM, EEI and muscle strength parameters.

Results: Statistically significant increase in GMFM score was observed between pre- and post measurements (89.13%±7.71-90.26%±7.53 p<0.05). Mean EEI was evaluated as 1.56±1.31 beat/metre, which has decreased to 1.42±1.12 beat/meter after the program (p=0.052). Muscle strength measurements of right (R) and left (L), flexor (F) and extensor (E) knee muscle groups showed significant increases; RF pre: 12.82±3.54 N-M, post: 15.44±6.43 N-M; LF pre: 12.51±3.39 N-M, post: 14.88±5.94 N-M; RE pre: 19.25±8.01 N-M, post: 24.38±11.42 N-M; LE pre: 19.55±7.95 N-M, post: 23.89±12.76 N-M (p<0.05).

Conclusion: Muscle weakness is a well-known finding in spastic CP. In this study isokinetic dynamometer enabled us to determine clinical evaluation objectively. Muscle strength measurements and strengthening exercises should be included in the rehabilitation programs for children with spastic CP.