A systematic review of the effectiveness of treadmill training for children with cerebral palsy

Willoughby, Kate; Dodd, Karen; Shields, Nora

doi:10.3109/09638280902874204

Cited by 113 publications

(73 citation statements)

References 30 publications

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“…The development of efficient and independent walking is an important therapeutic goal for many children with CP (Willoughby et al, 2009; Smania et al, 2011; Degelean et al, 2012; Graham et al, 2016). Given a positive effect of repetitive locomotor exercise on gait characteristics in children with CP (Smania et al, 2011), the rehabilitative protocol may further focus on improving the structure of the spinal locomotor output, e.g., by providing a feedback on the basic activation pattern burst durations.…”

Section: Discussionmentioning

confidence: 99%

Immature Spinal Locomotor Output in Children with Cerebral Palsy

et al. 2016

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Detailed descriptions of gait impairments have been reported in cerebral palsy (CP), but it is still unclear how maturation of the spinal motoneuron output is affected. Spatiotemporal alpha-motoneuron activation during walking can be assessed by mapping the electromyographic activity profiles from several, simultaneously recorded muscles onto the anatomical rostrocaudal location of the motoneuron pools in the spinal cord, and by means of factor analysis of the muscle activity profiles. Here, we analyzed gait kinematics and EMG activity of 11 pairs of bilateral muscles with lumbosacral innervation in 35 children with CP (19 diplegic, 16 hemiplegic, 2–12 years) and 33 typically developing (TD) children (1–12 years). TD children showed a progressive reduction of EMG burst durations and a gradual reorganization of the spatiotemporal motoneuron output with increasing age. By contrast, children with CP showed very limited age-related changes of EMG durations and motoneuron output, as well as of limb intersegmental coordination and foot trajectory control (on both sides for diplegic children and the affected side for hemiplegic children). Factorization of the EMG signals revealed a comparable structure of the motor output in children with CP and TD children, but significantly wider temporal activation patterns in children with CP, resembling the patterns of much younger TD infants. A similar picture emerged when considering the spatiotemporal maps of alpha-motoneuron activation. Overall, the results are consistent with the idea that early injuries to developing motor regions of the brain substantially affect the maturation of the spinal locomotor output and consequently the future locomotor behavior.

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Section: Discussionmentioning

confidence: 99%

Immature Spinal Locomotor Output in Children with Cerebral Palsy

et al. 2016

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“…18 In children with other chronic disorders, such programs have been implemented on a larger scale with positive effects on fitness and daily participation. [19][20][21] Looking more specifically at programs aimed to improve ambulation, treadmill training has shown promising results in other pediatric populations, 22 but there are some reservations because of methodological questions regarding study design and description of intensity and frequency of the intervention. 23 From a motor learning point of view and specificity of training effects, treadmill training is a task-specific training that allows repetitive practice of gait cycles, important for motor learning and neural plasticity.…”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Study of Home-Based Treadmill Training for Ambulatory Children With Spina Bifida

Groot

Takken

Brussel

et al. 2011

Neurorehabil Neural Repair

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“…Les é carts de force de ré action verticale par rapport au sol entre les membres en position debout, les paramè tres temporels-distance de dé marche et des dizaines de dimensions D et E de la mesure GMFM ont é té dé terminé s. Les participants ont pré senté une amé lioration statistiquement significative dans une mesure de GMFM (P < 0.01) et la valeur de ré partition du poids (P < 0.05), la vitesse de marche avant (P < 0.05) et la longueur de pas Introduction Achievement of efficient and independent locomotion with or without assistance is an important functional goal for many children with cerebral palsy (CP). Forward walking (FW) on a treadmill provides an increased opportunity to train the entire gait cycle, facilitating an enhanced gait pattern in both ambulatory and nonambulatory children with CP (Willoughby et al, 2009), and it has been shown to provide a range of benefits (Begnoche and Pitetti, 2007;Cherng et al, 2007;Dodd and Foley, 2007;Provost et al, 2007). Recently, some therapists have advocated backward walking (BW) on a treadmill or over ground in clinical practice to treat patients in rehabilitation for sports or functional mobility/gait.…”

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confidence: 99%

Backward walking treadmill therapy can improve walking ability in children with spastic cerebral palsy

Kim

Ryu

et al. 2013

International Journal of Rehabilitation Research

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The aim of this study was to determine whether an 8-week period of backward walking (BW) training on the treadmill can improve the gross motor function measure (GMFM), weight-bearing symmetry, and temporospatial gait parameters in individuals with spastic cerebral palsy. Twelve participants aged 5-15 years with spastic cerebral palsy participated in this study. The BW training was conducted on a treadmill for up to 20 min, with three sessions per week for 8 consecutive weeks. Before each treadmill training session, lower limb stretching was included in the session. Interlimb differentials of vertical ground reaction force while standing, temporal-distance gait parameters, and scores of dimension D and dimension E of the GMFM were determined. Participants showed statistically significant improvements in a measure of GMFM (P<0.01) and weight-bearing symmetry value (P<0.05), forward walking velocity (P<0.05), and step/stride length (P<0.05 or P<0.01). This pilot study suggests that BW therapy on a treadmill may help to improve walking abilities and other gross motor skills in this sample of patients.

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A systematic review of the effectiveness of treadmill training for children with cerebral palsy

Cited by 113 publications

References 30 publications

Immature Spinal Locomotor Output in Children with Cerebral Palsy

Immature Spinal Locomotor Output in Children with Cerebral Palsy

Randomized Controlled Study of Home-Based Treadmill Training for Ambulatory Children With Spina Bifida

Backward walking treadmill therapy can improve walking ability in children with spastic cerebral palsy

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