Efficacy of Partial Body Weight–Supported Treadmill Training Compared With Overground Walking Practice for Children With Cerebral Palsy: A Randomized Controlled Trial

• Published in: Archives of physical medicine and rehabilitation Vol. 91; no. 3; pp. 333 - 339
• Main Authors: Willoughby, Kate L., BPhysio, Dodd, Karen J., PhD, BAppSc (Physio), Shields, Nora, PhD, Foley, Sarah, BAppSc (Physio), Grad Dip Hlth Res Meth
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2010; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Cerebral palsy; Cerebral Palsy - rehabilitation; Child; Child, Preschool; Diseases of the osteoarticular system; Exercise Test; Exercise therapy; Exercise Therapy - methods; Female; Gait; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Miscellaneous; Nervous system (semeiology, syndromes); Neurology; Physical Medicine and Rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Treatment Outcome; Walking; PBWSTT; Cerebral palsy; 10MWT; Gross Motor Function Classification System; Gait; CI; partial body weight–supported treadmill training; CP; Walking; Exercise therapy; confidence interval; Rehabilitation; ten minute walk test; GMFCS; Child; Human; Physical exercise; Nervous system diseases; Body weight; Corporal biometry; Cerebral disorder; Reeducation; Treatment; Partial; Orthopedics; Central nervous system disease
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2009.10.029

Abstract Willoughby KL, Dodd KJ, Shields N, Foley S. Efficacy of partial body weight–supported treadmill training compared with overground walking practice for children with cerebral palsy: a randomized controlled trial. Objective To evaluate the efficacy of 9 weeks of twice-weekly partial body weight–supported treadmill training (PBWSTT) for children with cerebral palsy (CP) and moderate to severe walking difficulty compared with overground walking. Design Randomized controlled trial. Setting Metropolitan Specialist School for children with moderate to severe physical and/or intellectual disabilities. Participants Thirty-four children classified level III or IV by the Gross Motor Function Classification System were recruited and randomly allocated to experimental or control groups. Of these, 26 (15 girls, 11 boys; mean age 10y, 10mo ± 3y, 11mo [range, 5–18y]) completed training and testing. Interventions Both groups completed 9 weeks of twice-weekly walking training. The experimental group completed PBWSTT, and the control group completed overground walking practice. Main Outcome Measures Ten-meter walk test (self-selected walking speed), 10-minute walk (walking endurance), School Function Assessment. Results The overground walking group showed a trend for an increase in the distance walked over 10 minutes (F=3.004, P =.097). There was no statistically significant difference in self-selected walking speed over 10 meters or in walking function in the school environment as measured by the School Function Assessment. Conclusions PBWSTT is safe and feasible to implement in a special school setting; however, it may be no more effective than overground walking for improving walking speed and endurance for children with CP. Continued emphasis on progressive reduction of body weight support along with adding concurrent overground walking practice to a treadmill training protocol may increase the intensity of training and assist with carryover of improvements to overground walking. Treadmill training programs that include concurrent overground walking as an additional key feature of the training protocol need to be rigorously evaluated for children with CP.