Article

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 10 y,
10 mo +/- 3 y, 11 mo [range, 5-18 y]) 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.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS