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Treadmill Training for Children and Youth with Cerebral Palsy

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Cerebral Palsy

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Abstract

The aim of treadmill training is to promote gait acquisition or improvement of gait quality by using a motorized belt which allows for multiple repetitions within a treatment session and stepping without requiring forward propulsion. Treadmill training can be done using a variety of devices – from inexpensive exercise treadmills to split-belt or force-plate embedded devices that can be used with dynamic partial body weight support. Treadmill training can be safely performed with children at GMFCS levels I–IV, and intervention dosing and progression should be tailored to the goals of the therapy. Treadmill training has the potential to address body function and structure impairments, activity limitations, and participation restrictions, while the greatest evidence is for improvements in walking speed over short distances.

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References

  • Auxter D (1969) Suggestion from the field. Use of the treadmill for gait training. Phys Ther 49:1386–1387

    Article  CAS  PubMed  Google Scholar 

  • Azizi S, Marzbani H, Raminfard S, Birgani PM, Rasooli AH, Mirbagheri MM (2017) The impact of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with cerebral palsy. Conf Proc IEEE Eng Med Biol Soc 2017:1150–1153

    Google Scholar 

  • Bulea TC, Stanley CJ, Damiano DL (2017) Part 2: Adaptation of Gait kinematics in unilateral cerebral palsy demonstrates preserved independent neural control of each limb. Front Hum Neurosci 11:50

    Article  PubMed  PubMed Central  Google Scholar 

  • Carey H, Martin K, Combs-Miller S, Heathcock JC (2016) Reliability and responsiveness of the timed up and go test in children with cerebral palsy. Pediatr Phys Ther 28:401–408

    Article  PubMed  Google Scholar 

  • Carswell A, Mccoll MA, Baptiste S, Law M, Polatajko H, Pollock N (2004) The Canadian occupational performance measure: a research and clinical literature review. Can J Occup Ther 71:210–222

    Article  PubMed  Google Scholar 

  • Damiano DL, Dejong SL (2009) A systematic review of the effectiveness of treadmill training and body weight support in pediatric rehabilitation. J Neurol Phys Ther 33:27–44

    Article  PubMed  PubMed Central  Google Scholar 

  • Damiano DL, Stanley CJ, Bulea TC, Park HS (2017) Motor learning abilities are similar in hemiplegic cerebral palsy compared to controls as assessed by adaptation to unilateral leg-weighting during gait: part I. Front Hum Neurosci 11:49

    Article  PubMed  PubMed Central  Google Scholar 

  • Dodd KJ, Foley S (2007) Partial body-weight-supported treadmill training can improve walking in children with cerebral palsy: a clinical controlled trial. Dev Med Child Neurol 49:101–105

    Article  PubMed  Google Scholar 

  • Fitzgerald D, Hickey C, Delahunt E, Walsh M, O’brien T (2016) Six-minute walk test in children with spastic cerebral palsy and children developing typically. Pediatr Phys Ther 28:192–199

    Article  PubMed  Google Scholar 

  • Fowler E, Moulton T (2020) Motor control in children and youth with cerebral palsy. In: Miller F, Bacarach S, Lennon N, O’Neil M (eds) Cerebral palsy, 2nd edn. Springer

    Google Scholar 

  • Fowler EG, Staudt LA, Greenberg MB, Oppenheim WL (2009) Selective Control Assessment of the Lower Extremity (SCALE): development, validation, and interrater reliability of a clinical tool for patients with cerebral palsy. Dev Med Child Neurol 51:607–614

    Article  PubMed  Google Scholar 

  • Franjoine MR, Gunther JS, Taylor MJ (2003) Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther 15:114–128

    Article  PubMed  Google Scholar 

  • Gates PE, Banks D, Johnston TE, Campbell SR, Gaughan JP, Ross SA, Engsberg JR, Tucker C (2012) Randomized controlled trial assessing participation and quality of life in a supported speed treadmill training exercise program vs. a strengthening program for children with cerebral palsy. J Pediatr Rehabil Med 5:75–88

    Article  CAS  PubMed  Google Scholar 

  • Gorton GE 3rd, Watson K, Tucker CA, Tian F, Montpetit K, Haley SM, Mulcahey MJ (2010) Precision and content range of a parent-reported item bank assessing lower extremity and mobility skills in children with cerebral palsy. Dev Med Child Neurol 52:660–665

    Article  PubMed  Google Scholar 

  • Graham HK, Harvey A, Rodda J, Nattrass GR, Pirpiris M (2004) The Functional Mobility Scale (FMS). J Pediatr Orthop 24:514–520

    Article  PubMed  Google Scholar 

  • Grecco LA, Tomita SM, Christovao TC, Pasini H, Sampaio LM, Oliveira CS (2013) Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial. Braz J Phys Ther 17:17–23

    Article  PubMed  Google Scholar 

  • Haley SM, Coster WI, Kao YC, Dumas HM, Fragala-Pinkham MA, Kramer JM, Ludlow LH, Moed R (2010) Lessons from use of the Pediatric Evaluation of Disability Inventory: where do we go from here? Pediatr Phys Ther 22:69–75

    Article  PubMed  PubMed Central  Google Scholar 

  • Harkema SJ, Hillyer J, Schmidt-Read M, Ardolino E, Sisto SA, Behrman AL (2012a) Locomotor training: as a treatment of spinal cord injury and in the progression of neurologic rehabilitation. Arch Phys Med Rehabil 93:1588–1597

    Article  PubMed  Google Scholar 

  • Harkema SJ, Schmidt-Read M, Lorenz DJ, Edgerton VR, Behrman AL (2012b) Balance and ambulation improvements in individuals with chronic incomplete spinal cord injury using locomotor training-based rehabilitation. Arch Phys Med Rehabil 93:1508–1517

    Article  PubMed  Google Scholar 

  • Harvey A, Graham HK, Morris ME, Baker R, Wolfe R (2007) The Functional Mobility Scale: ability to detect change following single event multilevel surgery. Dev Med Child Neurol 49:603–607

    Article  PubMed  Google Scholar 

  • Held SL, Kott KM, Young BL (2006) Standardized Walking Obstacle Course (SWOC): reliability and validity of a new functional measurement tool for children. Pediatr Phys Ther 18:23–30

    Article  PubMed  Google Scholar 

  • Helm EE, Reisman DS (2015) The split-belt walking paradigm: exploring motor learning and spatiotemporal asymmetry poststroke. Phys Med Rehabil Clin N Am 26:703–713

    Article  PubMed  PubMed Central  Google Scholar 

  • Hodapp M, Vry J, Mall V, Faist M (2009) Changes in soleus H-reflex modulation after treadmill training in children with cerebral palsy. Brain 132:37–44

    Article  PubMed  Google Scholar 

  • Johnston TE, Watson KE, Ross SA, Gates PE, Gaughan JP, Lauer RT, Tucker CA, Engsberg JR (2011) Effects of a supported speed treadmill training exercise program on impairment and function for children with cerebral palsy. Dev Med Child Neurol 53:742–750

    Article  PubMed  Google Scholar 

  • Kerr C, Mcdowell BC, Cosgrove A (2007) Oxygen cost versus a 1-minute walk test in a population of children with bilateral spastic cerebral palsy. J Pediatr Orthop 27:283–287

    Article  PubMed  Google Scholar 

  • Kim OY, Shin YK, Yoon YK, Ko EJ, Cho SR (2015) The effect of treadmill exercise on gait efficiency during overground walking in adults with cerebral palsy. Ann Rehabil Med 39:25–31

    Article  PubMed  PubMed Central  Google Scholar 

  • King GA, Law M, King S, Hurley P, Hanna S, Kertoy M, rosenbaum P (2007) Measuring children’s participation in recreation and leisure activities: construct validation of the CAPE and PAC. Child Care Health Dev 33:28–39

    Article  CAS  PubMed  Google Scholar 

  • Kurz MJ, Corr B, Stuberg W, Volkman KG, Smith N (2011) Evaluation of lower body positive pressure supported treadmill training for children with cerebral palsy. Pediatr Phys Ther 23:232–239

    Article  PubMed  Google Scholar 

  • Kurz MJ, Wilson TW, Corr B, Volkman KG (2012) Neuromagnetic activity of the somatosensory cortices associated with body weight-supported treadmill training in children with cerebral palsy. J Neurol Phys Ther 36:166–172

    Article  PubMed  Google Scholar 

  • Law M, Baptiste S, Mccoll M, Opzoomer A, Polatajko H, Pollock N (1990) The Canadian occupational performance measure: an outcome measure for occupational therapy. Can J Occup Ther 57:82–87

    Article  CAS  PubMed  Google Scholar 

  • Lite Gait: https://www.litegait.com; and Pediatric Lite Gait: https://www.litegait.com/products/pediatric-litegait. Accessed 19 Sept 2019

  • Looper J, Ulrich DA (2010) Effect of treadmill training and supramalleolar orthosis use on motor skill development in infants with down syndrome: a randomized clinical trial. Phys Ther 90:382–390

    Article  PubMed  Google Scholar 

  • Mattern-Baxter K (2009) Effects of partial body weight supported treadmill training on children with cerebral palsy. Pediatr Phys Ther 21:12–22

    Article  PubMed  Google Scholar 

  • Mattern-Baxter K, Mcneil S, Mansoor JK (2013) Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial. Arch Phys Med Rehabil 94:2061–2067

    Article  PubMed  Google Scholar 

  • Mawase F, Bar-Haim S, Joubran K, Rubin L, Karniel A, Shmuelof L (2016) Increased adaptation rates and reduction in trial-by-trial variability in subjects with cerebral palsy following a multi-session locomotor adaptation training. Front Hum Neurosci 10:203

    Article  PubMed  PubMed Central  Google Scholar 

  • Mcdowell BC, Kerr C, Parkes J, Cosgrove A (2005) Validity of a 1 minute walk test for children with cerebral palsy. Dev Med Child Neurol 47:744–748

    Article  PubMed  Google Scholar 

  • Mehrholz J, Kugler J, Pohl M (2012) Locomotor training for walking after spinal cord injury. Cochrane Database Syst Rev 11:CD006676

    PubMed  Google Scholar 

  • Mehrholz J, Thomas S, Elsner B (2017) Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev 8:CD002840

    PubMed  Google Scholar 

  • Miller F (2020) Cerebral palsy gait pathology, section 3.1. In: Miller F, Bacarach S, Lennon N, O’Neil M (eds) Cerebral Palsy, 2nd edn. Springer

    Google Scholar 

  • Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH (2008) Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol 50:744–750

    Article  PubMed  Google Scholar 

  • Palisano RJ, Orlin M, Chiarello LA, Oeffinger D, Polansky M, Maggs J, Gorton G, Bagley A, Tylkowski C, Vogel L, Abel M, Stevenson R (2011) Determinants of intensity of participation in leisure and recreational activities by youth with cerebral palsy. Arch Phys Med Rehabil 92:1468–1476

    Article  PubMed  Google Scholar 

  • Phillips JP, Sullivan KJ, Burtner PA, Caprihan A, Provost B, Bernitsky-Beddingfield A (2007) Ankle dorsiflexion fMRI in children with cerebral palsy undergoing intensive body-weight-supported treadmill training: a pilot study. Dev Med Child Neurol 49:39–44

    Article  PubMed  Google Scholar 

  • Provost B, Dieruf K, Burtner PA, Phillips JP, Bernitsky-Beddingfield A, Sullivan KJ, Bowen CA, Toser L (2007) Endurance and gait in children with cerebral palsy after intensive body weight-supported treadmill training. Pediatr Phys Ther 19:2–10

    Article  PubMed  Google Scholar 

  • Reisman DS, Wityk R, Silver K, Bastian AJ (2007) Locomotor adaptation on a split-belt treadmill can improve walking symmetry post-stroke. Brain 130:1861–1872

    Article  PubMed  Google Scholar 

  • Robertson R, Goss FL, Aaron DJ, Tessmer KA, Gairola A, Ghigarelli JJ, Kowalis RA, Thekkada S, Liu Y, Randall CR, Weary KA (2006) Observation of perceived exertion in children using the OMNI pictorial scale. Med Sci Sports Exerc 38:9

    Article  Google Scholar 

  • Rosenbaum PL, Palisano RJ, Bartlett DJ, Galuppi BE, Russell DJ (2008) Development of the Gross Motor Function Classification System for cerebral palsy. Dev Med Child Neurol 50:249–253

    Article  PubMed  Google Scholar 

  • Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ (2000) Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther 80:873–885

    CAS  PubMed  Google Scholar 

  • Russell DJ, Avery LM, Walter SD, Hanna SE, Bartlett DJ, Rosenbaum PL, Palisano RJ, Gorter JW (2010) Development and validation of item sets to improve efficiency of administration of the 66-item Gross Motor Function Measure in children with cerebral palsy. Dev Med Child Neurol 52:e48–e54

    Article  PubMed  Google Scholar 

  • Schindl MR, Forstner C, Kern H, Hesse S (2000) Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy. Arch Phys Med Rehabil 81:6

    Article  Google Scholar 

  • Tang R, Kim J, Gaebler-Spira DJ, Wu M (2018) Gradual increase of perturbation load induces a longer retention of locomotor adaptation in children with cerebral palsy. Hum Mov Sci 63:20–33

    Article  PubMed  PubMed Central  Google Scholar 

  • Ulrich DA, Lloyd MC, Tiernan CW, Looper JE, Angulo-Barroso RM (2008) Effects of intensity of treadmill training on developmental outcomes and stepping in infants with down syndrome: a randomized trial. Phys Ther 88:114–122

    Article  PubMed  Google Scholar 

  • Valentin-Gudiol M, Bagur-Calafat C, Girabent-Farres M, Hadders-Algra M, Mattern-Baxter K, Angulo-Barroso R (2013) Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay: a report of a Cochrane systematic review and meta-analysis. Eur J Phys Rehabil Med 49:67–91

    CAS  PubMed  Google Scholar 

  • Van Der Krogt MM, Sloot LH, Harlaar J (2014) Overground versus self-paced treadmill walking in a virtual environment in children with cerebral palsy. Gait Posture 40:587–593

    Article  PubMed  Google Scholar 

  • Verschuren O, Takken T, Ketelaar M, Gorter JW, Helders PJM (2006) Reliability and validity of data for 2 newly developed shuttle run tests in children with cerebral palsy. Phys Ther 86:10

    Google Scholar 

  • Visser A, Westman M, Otieno S, Kenyon L (2017) A home-based body weight-supported treadmill program for children with cerebral palsy: a pilot study. Pediatr Phys Ther 29:223–229

    Article  PubMed  Google Scholar 

  • Wang HH, Liao HF, Hsieh CL (2006) Reliability, sensitivity to change, and responsiveness of the peabody developmental motor scales-second edition for children with cerebral palsy. Phys Ther 86:1351–1359

    Article  PubMed  Google Scholar 

  • Willoughby KL, Dodd KJ, Shields N (2009) A systematic review of the effectiveness of treadmill training for children with cerebral palsy. Disabil Rehabil 31:1971–1979

    Article  PubMed  Google Scholar 

  • Willoughby KL, Dodd KJ, Shields N, Foley S (2010) 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 91:333–339

    Article  PubMed  Google Scholar 

  • World Health Organization (2013) How to use the ICF: a practical manual for using the International Classification of Functioning. In: Disability and health: exposure draft for comment. WHO, Geneva

    Google Scholar 

  • Wu J, Looper J, Ulrich DA, Angulo-Barroso RM (2010) Effects of various treadmill interventions on the development of joint kinematics in infants with down syndrome. Phys Ther 90:1265–1276

    Article  PubMed  Google Scholar 

  • Wu M, Kim J, Arora P, Gaebler-Spira DJ, Zhang Y (2016) Kinematic and EMG responses to pelvis and leg assistance force during treadmill walking in children with cerebral palsy. Neural Plast 2016:5020348

    PubMed  PubMed Central  Google Scholar 

  • Wu M, Kim J, Gaebler-Spira DJ, Schmit BD, Arora P (2017) Robotic resistance treadmill training improves locomotor function in children with cerebral palsy: a randomized controlled pilot study. Arch Phys Med Rehabil 98:2126–2133

    Article  PubMed  PubMed Central  Google Scholar 

  • Zero G Gait and Balance System: https://www.aretechllc.com/. Accessed 19 Sept 2019

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Author information

Authors and Affiliations

  1. Physical Therapy, Arcadia University, Glenside, PA, USA

    Ann Tokay Harrington

Authors
  1. Ann Tokay Harrington
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Correspondence to Ann Tokay Harrington .

Editor information

Editors and Affiliations

  1. Alfred I. duPont Institute, Wilmington, DE, USA

    Freeman Miller

  2. Cerebral Palsy Program, AI DuPont Hospital for Children, Wilmington, DE, USA

    Steven Bachrach

  3. AI DuPont Hospital for Children, Wilmington, DE, USA

    Nancy Lennon

  4. Drexel University, PHILADELPHIA, PA, USA

    Margaret O'Neil

Section Editor information

  1. AI duPont Hospital for Children, Wilmington, DE, USA

    Nancy Lennon

  2. Columbia University, New York, NY, USA

    Margaret E. O’Neil

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Harrington, A.T. (2020). Treadmill Training for Children and Youth with Cerebral Palsy. In: Miller, F., Bachrach, S., Lennon, N., O'Neil, M. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-50592-3_173-1

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  • DOI: https://doi.org/10.1007/978-3-319-50592-3_173-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50592-3

  • Online ISBN: 978-3-319-50592-3

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