Activity, including gross motor function measure (GMFM), other gross motor measures, sit-to-stand activities, and stair
climbing showed 30 numbers and moderate (d = 0.668) ES. The ES appeared smaller than in the review by Dodd et al. (2002).
The total score of GMFM showed no significant effect in the review by Dodd et al. (2002), but GMFM and other measures of
gross motor function in this meta-analysis found moderate ES. Since performance was affected by many factors, such as
sensory acuity and coordination, strengthening focused on increasing muscle strength might have a smaller ES than muscle
strength. Dodd et al. (2002) suggested that an individualized exercise program was needed to draw out better functional
outcomes of strengthening in individuals with CP. The moderate ES of activity in this meta-analysis indicates that further
studies of specific strengthening programs focused on individual activity needs should be performed.