Highlights
- •Children with cerebral palsy underwent 6 weeks (3 times a week) of robotic treadmill training.
- •An assistance/resistance load was applied to both legs to help/hinder the swing phase.
- •Resistance training is more effective than assistance training in improving walking function.
Abstract
Objective
To determine whether applying controlled resistance forces to the legs during the
swing phase of gait may improve the efficacy of treadmill training as compared with
applying controlled assistance forces in children with cerebral palsy (CP).
Design
Randomized controlled study.
Setting
Research unit of a rehabilitation hospital.
Participants
Children with spastic CP (N=23; mean age, 10.6y; range, 6–14y; Gross Motor Function
Classification System levels, I–IV).
Interventions
Participants were randomly assigned to receive controlled assistance (n=11) or resistance
(n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill
training 3 times a week for 6 weeks (18 sessions). A controlled swing assistance/resistance
load was applied to both legs starting from the toe-off to mid-swing phase of gait
during training.
Main Outcome Measures
Outcome measures consisted of overground walking speed, 6-minute walk distance, and
Gross Motor Function Measure scores and were assessed pre and post 6 weeks of training
and 8 weeks after the end of training.
Results
After 6 weeks of treadmill training in participants from the resistance training group,
fast walking speed and 6-minute walk distance significantly improved (18% and 30%
increases, respectively), and 6-minute walk distance was still significantly greater
than that at baseline (35% increase) 8 weeks after the end of training. In contrast,
overground gait speed and 6-minute walk distance had no significant changes after
robotic assistance training.
Conclusions
The results of the present study indicated that robotic resistance treadmill training
is more effective than assistance training in improving locomotor function in children
with CP.
Keywords
List of abbreviations:
ANOVA (analysis of variance), CP (cerebral palsy), GMFCS (Gross Motor Function Classification System), GMFM (Gross Motor Function Measure), IQR (interquartile range), RPE (rating of perceived exertion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 30, 2017
Footnotes
Supported by the National Institutes of Health (grant no. 1R21HD066261).
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
