Effects plyometric exercise in children with cerebral palsy: a systematic review

Authors

  • Alba María Alvedro-Arcay Universidade de Vigo, Facultade de Fisioterapia, Campus A Xunqueira, Galicia, España. Equipo de Investigación en Rendemento e Motricidade do Salvamento e Socorrismo, Galicia, España..
  • Gloria María Cascallar-Cascallar Universidade de Vigo, Facultade de Fisioterapia, Campus A Xunqueira, Galicia, España. Equipo de Investigación en Rendemento e Motricidade do Salvamento e Socorrismo, Galicia, España.. https://orcid.org/0009-0000-2075-4502
  • Yoana González González
  • Alejandra Alonso-Calvete Universidade de Vigo, Facultade de Fisioterapia, Campus A Xunqueira, Galicia, España. Equipo de Investigación en Rendemento e Motricidade do Salvamento e Socorrismo, Galicia, España.. https://orcid.org/0000-0003-4386-1559

DOI:

https://doi.org/10.47197/retos.v84.115973

Keywords:

Cerebral palsy, physical activity, physical therapy modalities, plyometric training, rehabilitation

Abstract

Introduction: Cerebral palsy is the leading cause of physical disability in childhood and is associated with impairments in movement, posture, and motor function that limit participation in physical activity and daily life. In this context, plyometric training has emerged as a potential strategy to enhance neuromuscular performance.

Objective: To analyze the scientific evidence on the effects of plyometric training in the pediatric population with cerebral palsy.

Methodology: A systematic review was conducted following the PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, PEDro, MEDLINE, and SPORTDiscus using the terms cerebral palsy, plyometric exercise, plyometric training, and children. Seven studies published in English or Spanish that evaluated plyometric exercise interventions in pediatric populations with cerebral palsy were included. Methodological quality was assessed using the PEDro scale.

Results: The included studies primarily involved pediatric participants with unilateral cerebral palsy and Gross Motor Function Classification System levels I-II. Interventions varied in frequency and duration but generally followed progressive plyometric training principles. Improvements were reported in gait performance, muscle strength, balance, and motor function. The most favorable outcomes were observed when plyometric training was combined with balance exercises.

Conclusions: Plyometric training appears to be a safe and promising intervention for improving motor function in the pediatric population with cerebral palsy. However, the limited number of studies and the existing methodological heterogeneity highlight the need for high-quality randomized controlled trials to confirm these findings.

References

Abd‐elmonem, A. M., Ali, H. A., Saad‐eldien, S. S., & El‐nabie, W. A. A. (2024). Efficacy of plyometric ex-ercises on upper extremity function, selective motor control and hand grip strength in children with unilateral cerebral palsy: A randomized controlled study. Physiotherapy Research Interna-tional, 29(1), e2061. https://doi.org/10.1002/pri.2061

Aguirre Chávez, J. F., Robles Hernández, G. S. I., Franco Gallegos, L. I., & Montes Mata, K. J. (2025). Super-ando barreras: educación física inclusiva para estudiantes con necesidades educativas especial-es. Una revisión documental. Retos, 69, 102-109. https://doi.org/10.47197/retos.v69.112434

Auld, M. L., & Johnston, L. M. (2014). “Strong and steady”: A community-based strength and balance exercise group for children with cerebral palsy. Disability and Rehabilitation, 36(24), 2065-2071. https://doi.org/10.3109/09638288.2014.891054

Bruhn, S., Kullmann, N., & Gollhofer, A. (2006). Combinatory Effects of High-Intensity-Strength Training and Sensorimotor Training on Muscle Strength. International Journal of Sports Medicine, 27(5), 401-406. https://doi.org/10.1055/s-2005-865750

Camargo-Rojas, D. A., Delgado-Castrillón, J. V., García-Cabrera, V., Estupiñán-González, L. M., Medina-Garzón, P. M., Muñoz-Hinrichsen, F., & Torres-Paz, L. E. (2023). Estado del arte de la investi-gación en discapacidad y actividad física en Sudamérica: Una revisión narrativa. Retos, 48, 945-968. https://doi.org/10.47197/retos.v48.95286

Chaouachi, A., Othman, A. B., Hammami, R., Drinkwater, E. J., & Behm, D. G. (2014). The Combination of Plyometric and Balance Training Improves Sprint and Shuttle Run Performances More Often Than Plyometric-Only Training With Children. Journal of Strength and Conditioning Research, 28(2), 401-412. https://doi.org/10.1519/JSC.0b013e3182987059

Chimera, N. J., Swanik, K. A., Swanik, C. B., & Straub, S. J. (2004). Effects of Plyometric Training on Mus-cle-Activation Strategies and Performance in Female Athletes. Journal of Athletic Training, 39, 24-31.

Davies, G., Riemann, B. L., & Manske, R. (2015). CURRENT CONCEPTS OF PLYOMETRIC EXERCISE. International Journal of Sports Physical Therapy, 10(6), 760-786.

Dewar, R., Love, S., & Johnston, L. M. (2015). Exercise interventions improve postural control in children with cerebral palsy: A systematic review. Developmental Medicine & Child Neurology, 57(6), 504-520. https://doi.org/10.1111/dmcn.12660

Dodd, K. J., Taylor, N. F., & Graham, H. K. (2003). A randomized clinical trial of strength training in young people with cerebral palsy. Developmental Medicine & Child Neurology, 45(10), 652-657. https://doi.org/10.1111/j.1469-8749.2003.tb00866.x

Elnaggar, R. K. (2022). Effects of plyometric exercises on muscle-activation strategies and response-capacity to balance threats in children with hemiplegic cerebral palsy. Physiotherapy Theory and Practice, 38(9), 1165-1173. https://doi.org/10.1080/09593985.2020.1833389

Elnaggar, R. K., Alqahtani, B. A., Alsubaie, S. F., Mohamed, R. R., & Elbanna, M. F. (2021). Stretch-shortening cycle exercises can efficiently optimize gait-symmetry and balance capabilities in children with unilateral cerebral palsy: A randomized controlled trial. NeuroRehabilitation, 49(1), 139-149. https://doi.org/10.3233/NRE-210063

Elnaggar, R. K., Diab, R. H., Alghadier, M., & Azab, A. R. (2022)a. Block-sequence of plyometric and balance training is superior to the alternating-sequence for enhancing motor function in children with hemiplegic cerebral palsy: A comparative randomized clinical trial. Isokinetics and Exercise Science, 30(4), 373-383. https://doi.org/10.3233/IES-220005

Elnaggar, R. K., Elbanna, M. F., Mahmoud, W. S., & Alqahtani, B. A. (2019). Plyometric exercises: Subsequent changes of weight- bearing symmetry, muscle strength and walking performance in children with unilateral cerebral palsy. Journal Musculoskelet Neuronal Interact, 19(4), 507-515.

Elnaggar, R. K., Mahmoud, W. S., Alsubaie, S. F., & Abd El-Nabie, W. A. (2022)b. Effectiveness of a Multi-Modal Exercise Program Incorporating Plyometric and Balance Training in Children With Hemiplegic Cerebral Palsy: A Three-Armed Randomized Clinical Trial. Physical & Occupational Therapy In Pediatrics, 42(2), 113-129. https://doi.org/10.1080/01942638.2021.1964674

El-Shamy, S. M. (2018). Efficacy of Armeo® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children With Hemiplegic Cerebral Palsy. American Journal of Physical Medi-cine & Rehabilitation, 97(3), 164-169. https://doi.org/10.1097/PHM.0000000000000852

El-Shamy, S. M., & Abd El Kafy, E. M. (2014). Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy. Disability and Rehabilitation, 36(14), 1176-1183. https://doi.org/10.3109/09638288.2013.833312

Espinoza-Diaz, C. I., Amaguaya-Maroto, G., Culqui-Barrionuevo, M., Espinosa-Moya, J. , Silva-Acosta, J., Angulo-Procel, A. , Rivera-Pérez, J. & Avilés-Jaya, A.C. (2019). Prevalencia, factores de riesgo y características clínicas de la parálisis cerebral infantil. AVFT-Archivos Venezolanos de Farma-cología y Terapéutica, 38(6):778-89.

Fernández-Zamarro, I., Pérez-Rodríguez, M., Redondo-Fernández, Á., Archilla-Prat, C., & Pérez-Tejero, J. (2025). Rugby inclusivo con personas con discapacidad intelectual: la opinión de los repre-sentantes de los clubes en España. Retos, 63, 524-533. https://doi.org/10.47197/retos.v63.108809

Floriano-Rodríguez, R., Manrique-Plácido, J. M., Mostacero-Llerena, S. J., Espejo-Chacón, L. F., Montaño-Barbuda, J. J., & Contreras-Horna, R. F. (2025). Influencia del programa “Deporte Inclusivo 2023” en la calidad de vida de jóvenes con discapacidad en el Perú. Retos, 68, 1678-1695. https://doi.org/10.47197/retos.v68.116510

Gillett, J. G., Lichtwark, G. A., Boyd, R. N., & Barber, L. A. (2018). Functional Anaerobic and Strength Training in Young Adults with Cerebral Palsy. Medicine & Science in Sports & Exercise, 50(8), 1549-1557. https://doi.org/10.1249/MSS.0000000000001614

González‐Agüero, A., Vicente‐Rodríguez, G., Gómez‐Cabello, A., Ara, I., Moreno, L. A., & Casajús, J. A. (2012). A 21‐week bone deposition promoting exercise programme increases bone mass in young people with Down syndrome. Developmental Medicine & Child Neurology, 54(6), 552-556. https://doi.org/10.1111/j.1469-8749.2012.04262.x

Granacher, U., Gollhofer, A., & Kriemler, S. (2010). Effects of Balance Training on Postural Sway, Leg Extensor Strength, and Jumping Height in Adolescents. Research Quarterly for Exercise and Sport, 81(3), 245-251. https://doi.org/10.1080/02701367.2010.10599672

Hernández-Beltrán, V., Espada, M. C., Castelli Correia de Campos, L. F., Ferreira, C. C., Chalapud-Narváez, L. M., & Gamonales, J. M. (2024). Análisis de los beneficios del deporte inclusivo en el área de Educación Física. Revisión sistemática. Retos, 56, 128-140. https://doi.org/10.47197/retos.v56.102933

Johnson, B. A., Salzberg, C. L., & Stevenson, D. A. (2011). A systematic review: plyometric training programs for young children. Journal of Strength and Conditioning Research, 25(9), 2623-2633. https://doi.org/10.1519/JSC.0b013e318204caa0

Johnson, B. A., Salzberg, C. L., & Stevenson, D. A. (2012). Effects of a Plyometric Training Program for 3 Children With Neurofibromatosis Type 1. Pediatric Physical Therapy, 24(2), 199-208. https://doi.org/10.1097/PEP.0b013e31824d30ee

Kaya Kara, O., Livanelioglu, A., Yardımcı, B. N., & Soylu, A. R. (2019). The Effects of Functional Progres-sive Strength and Power Training in Children With Unilateral Cerebral Palsy. Pediatric Physical Therapy, 31(3), 286-295. https://doi.org/10.1097/PEP.0000000000000628

Lieber, R. L., & Fridén, J. (2000). Functional and clinical significance of skeletal muscle architecture. Muscle & Nerve, 23(11), 1647-1666. https://doi.org/10.1002/1097-4598(200011)23:11<1647::AID-MUS1>3.0.CO;2-M

Montenegro-Rueda, M., & Fernández-Cerero, J. (2024). El deporte inclusivo: Un camino hacia la equidad y la igualdad de oportunidades. Retos, 51, 356-364. https://doi.org/10.47197/retos.v51.100592

Moreau, N. G., Holthaus, K., & Marlow, N. (2013). Differential Adaptations of Muscle Architecture to High-Velocity Versus Traditional Strength Training in Cerebral Palsy. Neurorehabilitation and Neural Repair, 27(4), 325-334. https://doi.org/10.1177/1545968312469834

Morton, J. F., Brownlee, M., & McFadyen, A. K. (2005). The effects of progressive resistance training for children with cerebral palsy. Clinical Rehabilitation, 19(3), 283-289. https://doi.org/10.1191/0269215505cr804oa

Noreña-Osorno, M. S., Avalos-Ardila, C. N., González-Palacio, E. V., & Luna-Paternina, R. (2025). Evalua-ción de capacidades físicas de niños con discapacidad y sin discapacidad en una institución edu-cativa. Retos, 68, 272-285. https://doi.org/10.47197/retos.v68.108985

Ryan, J. M., Cassidy, E. E., Noorduyn, S. G., & O'Connell, N. E. (2017). Exercise interventions for cerebral palsy. Cochrane Database of Systematic Reviews, 2017(6), CD011660. https://doi.org/10.1002/14651858.CD011660.pub2

Sáez-Sáez De Villarreal, E., Requena, B., & Newton, R. U. (2010). Does plyometric training improve strength performance? A meta-analysis. Journal of Science and Medicine in Sport, 13(5), 513-522. https://doi.org/10.1016/j.jsams.2009.08.005

Swanik, K. A., Lephart, S. M., Swanik, C. B., Lephart, S. P., Stone, D. A., & Fu, F. H. (2002). The effects of shoulder plyometric training on proprioception and selected muscle performance characteris-tics. Journal of Shoulder and Elbow Surgery, 11(6), 579-586. https://doi.org/10.1067/mse.2002.127303

Van Vulpen, L. F., De Groot, S., Rameckers, E., Becher, J. G., & Dallmeijer, A. J. (2017). Improved Walking Capacity and Muscle Strength After Functional Power-Training in Young Children With Cerebral Palsy. Neurorehabilitation and Neural Repair, 31(9), 827-841. https://doi.org/10.1177/1545968317723750

Downloads

Published

30-05-2026

Issue

Section

Theoretical systematic reviews and/or meta-analysis

How to Cite

Alvedro-Arcay, A. M., Cascallar-Cascallar, G. M., González González, Y., & Alonso-Calvete, A. (2026). Effects plyometric exercise in children with cerebral palsy: a systematic review. Retos, 84, 209-224. https://doi.org/10.47197/retos.v84.115973