Effects of a supported speed treadmill training exercise program on impairment and function for children with cerebral palsy

Abstract

Aim To compare the effects of a supported speed treadmill training exercise program (SSTTEP) with exercise on spasticity, strength, motor control, gait spatiotemporal parameters, gross motor skills, and physical function. Method Twenty‐six children (14 males, 12 females; mean age 9y 6mo, SD 2y 2mo) with spastic cerebral palsy (CP; diplegia, n=12; triplegia, n=2; quadriplegia n=12; Gross Motor Function Classification System levels II–IV) were randomly assigned to the SSTTEP or exercise (strengthening) group. After a twice daily, 2‐week induction, children continued the intervention at home 5 days a week for 10 weeks. Data collected at baseline, after 12‐weeks’ intervention, and 4 weeks after the intervention stopped included spasticity, motor control, and strength; gait spatiotemporal parameters; Gross Motor Function Measure (GMFM); and Pediatric Outcomes Data Collection Instrument (PODCI). Results Gait speed, cadence, and PODCI global scores improved, with no difference between groups. No significant changes were seen in spasticity, strength, motor control, GMFM scores, or PODCI transfers and mobility. Post‐hoc testing showed that gains in gait speed and PODCI global scores were maintained in the SSTTEP group after withdrawal of the intervention. Interpretation Although our hypothesis that the SSTTEP group would have better outcomes was not supported, results are encouraging as children in both groups showed changes in function and gait. Only the SSTTEP group maintained gains after withdrawal of intervention.

Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial

“…Treadmill training is believed to contribute to postural control by allowing multiple repetitions of the steps of the gait cycle in a rhythmic pattern, thereby improving control between agonist and antagonist muscles and resulting in improved functional and static balance. Previous studies have demonstrated positive results from treadmill training on gait speed and endurance, gross motor function and cardiorespiratory fitness [15][16][17][18][19][20][21] . However, these studies do not address the possible effects of treadmill training on postural stability (static and functional balance).…”

“…Different approaches have been used to favor selective control and the coordination of muscle contrations during gait [13][14][15] . In recent years, locomotor training on a treadmill has been used in the treatment of children with CP in an attempt to maximize orthostatism and gait velocity [15][16][17][18][19][20][21] . Treadmill training is believed to contribute to postural control by allowing multiple repetitions of the steps of the gait cycle in a rhythmic pattern, thereby improving control between agonist and antagonist muscles and resulting in improved functional and static balance.…”

Effect of Treadmill Gait Training on Diplegic Children Swing Phase Gait Parameters

“…Spasticity causes wide range of ambulatory disorders which explains the individual difficulties in maintaining and restores both static and dynamic balance [25]. There is a strong relationship between balance and single leg support time which indicated as test to measure the upright postural stability after upper motor neuron lesion [26]. Further studies are also needed for determining more differences in the biomechanical strategies adopted by different types and severities of the cerebral palsy in order to develop better training programs.…”

Combination of Functional Electrical Stimulation and Noninvasive Spinal Cord Electrical Stimulation for Movement Rehabilitation of the Children with Cerebral Palsy

“…In recent years, locomotor training on a treadmill widely uses in the treatment of children with CP [16]. Functional electrical stimulation (FES) has been used to enhance the effect of locomotor training [15].…”