Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ming Wu, Janis Kim, Deborah J. Gaebler-Spira, Brian D. Schmit, Pooja Arora
ObjectiveTo determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training compared to applying controlled assistance forces in children with cerebral palsy (CP).DesignRandomized controlled study.SettingResearch unit of rehabilitation hospital.ParticipantsChildren with spastic CP (n = 23, average age 10.6 years old, ranged from 6-14, GMFCS levels: I to IV).InterventionsParticipants 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 toe-off to mid-swing phase of gait during training.Main outcome measuresOutcome measures consisted of overground walking speed, 6 minute walking distance, and GMFM scores, and were assessed pre, post 6 weeks of training, and 8 weeks after the end of training.ResultsFollowing 6 weeks of treadmill training for participants from the resistance training group, fast walking speed and 6 minute walking distance significantly improved (18% and 30% increases, respectively), and 6 minute walking distance was still significantly greater than baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6 minute walking distance had no significant changes after robotic assistance training.ConclusionResults from the current study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP.
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