Faculty Scholarly Dissemination Grants

Title

A Home-Based Body Weight Supported Treadmill Training Program For Children With Cerebral Palsy: A Case Series

Department

Physical Therapy

College

College of Health Professions

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND AND PURPOSE: Contemporary approaches to the treatment of children with cerebral palsy (CP) advocate a task-specific approach that emphasizes repetition and practice of specific tasks. Recent studies also suggest that children with CP may benefit from a body-weight supported treadmill training (BWSTT) program in clinical settings. To explore the potential impact of greater opportunities for practice and repetition of walking tasks, this case series was undertaken 1) to develop an intervention and measurement protocol and 2) to execute and analyze the outcomes of a home-based BWSTT program to improve functional ambulation in 3 children with CP. CASE DESCRIPTION: Three children with CP at Gross Motor Function Classification System (GMFCS) levels III or IV participated in this case series. Examination procedures included use of the Functional Assessment Questionnaire (FAQ), the 10-meter walk test, the Gross Motor Function Measure (GMFM-66), the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT), and the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD). A multi-sport harness with an accompanying ceiling mount system was used to set up the body-weight support apparatus over a treadmill in participants homes. At the onset of the case, Participant 1 required physical assistance and manual cueing to take steps on the treadmill when using the harness for support. Participants 2 and 3 were able to take steps on the treadmill when using the harness. Parents received education and training regarding execution of the home-based BWSTT program. Parents carried out the intervention over an 8-12 week period at a frequency of 3 times week for 15-20 minute sessions with rest breaks as needed. Parents documented details regarding each session (time walking on the treadmill, number of breaks, etc.) OUTCOMES: All of the families and children reported enjoying the home-based activity and found the harness system easy to use. Participant 1 did not demonstrate improvements in any of the outcome measures administered. Participant 2 increased from a score of 2 to a score of 4 on the FAQ and progressed from a GMFCS level IV to a GMFCS Level III. Participant 3 did not show significant improvements in gait speed over the 10-meter walk test but increased from a score of 6 to a score of 7 on the FAQ and was able to transition from using a walker as his primary assistive device to using bilateral walking poles. DISCUSSION: The 2 participants in this case who were able to take steps on the treadmill at the onset of the intervention period appeared to achieve functional gains following a home-based BWSTT program. In addition to functional gait and mobility outcomes, future research should explore the potential health and wellness benefits of the cardiovascular exercise provided though a home-based BWSTT program.

Conference Name

Section on Pediatrics Annual Conference

Conference Location

St. Louis, MO

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