Abstract
Objective
To compare the effect of low-intensity (LI) vs high-intensity (HI) treadmill training
(TT) on walking attainment and overall walking activity in children with cerebral
palsy (CP).
Design
Prospective, multisite, randomized controlled trial.
Setting
Homes of the participants.
Participants
Children with spastic diplegic CP, Gross Motor Function Classification System Level
I and II, ages 14-32 months (N=19; male, n=8).
Interventions
The children were randomized to LI TT (2×/wk for 6wk) (n=10) and HI TT (10×/wk for
6wk) (n=9). The TT was carried out by the families with weekly instruction by the
researchers.
Main Outcome Measures
Children were assessed at study onset, post intervention, and 1 and 4 months post
intervention with the Gross Motor Function Measure Dimension D/E (GMFM D/E), average
strides per day and percentage of time spent walking with accelerometers, the Peabody
Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Index Mobility
Scale, timed 10-m and 1-minute walk test, and Functional Mobility Scale. Blinding
was conducted for GMFM D/E and PDMS-2. Linear mixed effects regression models were
applied to all outcomes.
Results
No significant between-group differences were found in any outcome measure at any
of the time points. Children in the HI group did not show significant improvement
immediately following the intervention in GMFM E (P=.061), while children in the LI group did (P=.003), but no statistically significant differences were detected over time (P=.71). Children in the HI group showed better walking independence on the Functional
Mobility Scale at all postintervention assessments.
Conclusions
A twice-weekly dosage was equally effective in improving skills related to walking
compared with a 10×/wk program and can be more readily implemented into clinical practice.
Keywords
List of abbreviations:
CP (cerebral palsy), DS (down syndrome), FMS (Functional Mobility Scale), GMFCS (Gross Motor Function Classification System), GMFM D/E (Gross Motor Function Measure-66 Dimensions D and E), HI (high-intensity), LI (low-intensity), MCID (minimally clinically important difference), PDMS-2 (Peabody Developmental Motor Scales-2), PEDI (Pediatric Evaluation of Disability Inventory), TT (treadmill training), 1MWT (1-minute walk test), 10MWT (10-m walk test)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 31, 2019
Footnotes
Supported by the Thrasher Research Fund (grant no. 12492) and a California State University, Sacramento, College of Health and Human Services Summer Fellowship.
Clinical Trial Registration No.: NCT02424526.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
