Children with Cerebral Palsy have many motor deficits that lead to problems with ambulation.

1. Is body weight supported treadmill training more effective than treadmill training at improving gait efficiency and endurance in children with Cerebral Palsy? References Children with Cerebral Palsy have many motor deficits that lead to problems with ambulation. Deviations in normalized gait include: Reduced walking speed Endurance Decreased step and stride length Decreased speed Decreased toe clearance Reduced coordination of movement All affect the ability of a child with CP to ambulate independently and efficiency in home and community environments. Outcome measures used to evaluate: 10 m walk test 6 min and 10 min walk tests Gross Motor Function Measure-88 What defines Cerebral Palsy? Body-Weight Supported Treadmill Training Clinical Relevance Lauren Rouse, Laura Stigler Department of Physical Therapy Bellarmine University, Louisville, KY Treadmill Training Chrysagis N, Skordilis EK, Stavrou N, Grammatopoulou E, Koutsouki D. The effect of treadmill training on gross motor function and walking speed in ambulatory adolescents with cerebral palsy: a randomized controlled trial. Am J Phys Med Rehabil. 2012;91(9):747-60. Grecco LA, Zanon N, Sampaio LM, Oliveira CS. A comparison of treadmill training and overground walking in ambulant children with cerebral palsy: randomized controlled clinical trial. ClinRehabil. 2013 Kurz MJ, Stuberg W, Dejong SL. Body weight supported treadmill training improves the regularity of the stepping kinematics in children with cerebral palsy. Dev Neurorehabil. 2011;14(2):87-93. Molina-rueda F, Aguila-maturana AM, Molina-rueda MJ, Miangolarra-page JC. [Treadmill training with or without partial body weight support in children with cerebral palsy: systematic review and meta-analysis]. Rev Neurol. 2010;51(3):135-45. Willoughby KL, Dodd KJ, Shields N, Foley S. Efficacy of partial body weight-supported treadmill training compared with overground walking practice for children with cerebral palsy: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(3):333-9. Willoughby KL, Dodd KJ, Shields N. A systematic review of the effectiveness of treadmill training for children with cerebral palsy. DisabilRehabil. 2009;31(24):1971-9. Future Research Cerebral Palsy is a non-progressive lesion to the brain resulting from damage to an immature brain before, during, or soon after birth. Damage results in physical and cognitive deficits 1,4. Level of impairment and function is defined by the Gross Motor Functional Classification Scale, levels I-V, levels III-V being most severely impaired. Top reasons why body-weight supported treadmill training should be used: Children with GMFCS levels IV and V may particularly benefit from body-weight supported treadmill training for improvements in gait kinematics and endurance3,4,5,6. Gradual training process that is active, repetitive and task specific to facilitate attainment of a more normalized gait pattern in children with CP3,4,5,6. More effective than over ground training alone in children with CP5. Improvements in gait efficiency and endurance are a result of treatment, in children with CP3,4,5,6. Top reasons why treadmill training should be used: Treadmill training is a task specific approach to improve gait in children with CP1,2. Improvements in gait efficiency and endurance are results of treatment, in children with CP1,2. How should Physical Therapists apply this information? Body weight supported treadmill training may be more effective than treadmill training alone at improving gait mechanics and endurance in children with GMFCS levels IV and V2,3. Children who are capable of walking without body-weight support should do so to obtain maximum benefits2,3. Body weight supported treadmill training should be between 14%-50% body weight supported with gradual decreases in body weight support by 5% every other week. Continue with tactile cuing as necessary 3,4. Gait speed should gradually be increased with treatment sessions 30-45min. For up to 12 weeks1-6. Treadmill training should be combined with over-ground training in order to receive maximum benefits and carryover from treadmill training sessions 2,3,5. What does the literature say about Body-weight supported treadmill training? Body-weight supported treadmill training can be used to improve: Stride length and step length3,4. Self-selected walking velocity3,4,6 Walking endurance4,5,6 Gross motor function3. Outcome Measures Utilized : 10 min walk test 6 min walk test 10m timed walk Gross Motor Functional Measure A randomized control trial comparing the effects of body-weight supported treadmill training directly to treadmill training in individuals with cerebral palsy. Muscle activity in the trunk and lower extremity during treadmill training verses over ground walking. Muscle activity in the trunk and lower extremity during body-weight supported treadmill training verses over ground walking. Research dividing data collection into individual GMFCS levels I-V to determine best practice methods for this patient population. http://www.jumpstartpediatrictherapy.com/?attachment_id=1492 http://www.abclawcenters.com/blog/2013/11/07/boy-with-cerebral-palsy-scores-136150 http://www.cpsociety.org.nz/images/GMFCS%202-6%20years.jpg http://www.ca http://www.nationwidechildrens.org/cerebral-palsy-treatment rlinscreations.com/ • What does the literature say about treadmill training? • Treadmill training can be used to improve: • Walking velocity 1 • Walking endurance 2 • Gross motor function 1,2 • Outcome Measures Utilized: • 6 min walk test • Gross Motor Functional Measure