Article

Many ambulatory children with spina bifida (SB) decline in their
walking despite stable or even improved motor function. OBJECTIVE: The authors
evaluated the effects of a home-based treadmill training program on both
ambulatory function and aerobic fitness. METHODS: This randomized clinical trial
of 34 ambulatory children with SB allocated 18 to supervised treadmill training
for 12 weeks at home and 14 to usual care. Patients in home training exercised
twice a week at an intensity of 66% of HR(peak) (peak heart rate) and gradually
progressed from 70% to 140% of their individual walking speed. Main outcome
measures were obtained at baseline, after intervention, and 3 months
postintervention. Ambulation was measured using the 6-minute walk test (6MWT),
during which gross energy consumption (ECS(gross)) and energy cost were
calculated. Maximal exercise capacity was measured using an incremental treadmill
test. Both VO(2peak) and speed(peak) were recorded as outcome parameters.
RESULTS: After training, significant changes were seen between the groups for
6MWT (P = .002; d = 1.08), speed(peak) (P = .001; d = 1.14), VO(2peak) (P = .034;
d = 0.78), and ECS(gross) (P = .004; d = 1.01). Long-term effects were recorded
for 6MWT (P = .003; eta = 0.34), speed(peak) (P = .003; eta = 0.35), and
ECS(gross) (P = .014; eta = 0.29) but not for VO(2peak). CONCLUSION: A
home-based, progressive treadmill training program for ambulatory children with
SB has a large long-term effect on ambulation, with a moderate short-term effect
on VO(2peak).

Langue : ANGLAIS