Neuropediatrics 2005; 36 - P110
DOI: 10.1055/s-2005-868095

Effects on walking performance of a ten-day treadmill training scheme in children with cerebral palsy

J Vry 1, U Michaelis 2, M Faist 3, B Seiler-Kramer 4, K Schäfer 2, U Eisele 2, S Reinicke 1, F Mainberger 1, R Korinthenberg 1, V Mall 1
  • 1Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Freiburg, Neuropädiatrie und Muskelerkrankungen, Freiburg im Breisgau
  • 2Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Freiburg, Physiotherapie, Freiburg im Breisgau
  • 3Neurologische Klinik, Universitätsklinikum Freiburg, Freiburg im Breisgau
  • 4Ärztlich-Physiotherapeutische Partnerschaft Dr. Riedel/Seiler-Kramer/Schäfle, Freiburg im Breisgau

Background: Locomotor training on a treadmill is used successfully for rehabilitation of adults with spastic movement disorders. For nonambulatory children with cerebral palsy (CP) performing a training with partial body weight support over several months, a positive effect has been demonstrated. The purpose of this pilot study is to determine whether a brief, intensive treadmill training without body weight support is feasible and may improve walking abilities in ambulatory children with spastic diplegia.

Methods: 9 children with CP [4 female, 5 male, age 5–14 years, median 9.3yrs, Gross Motor Function Classification Score (GMFCS) I: n=1, II: n=4, III: n=2, IV: n=2] performed a 10-minute locomotor training on a treadmill for 10 consecutive days. Treadmill speed was chosen individually by the patient with the option of adjusting speed during training. If necessary, a physiotherapist provided support. We measured the maximum walking distance within 6 minutes at the beginning and the end of the training. Additionally, the sections “walking“ and “standing“ of the Gross Motor Function Measure (GMFM) were performed.

Results: All children completed the training. One child missed the final assessment due to acute illness and was excluded from analysis. Before training started, the maximum walking distance within 6 minutes was between 31 m and 538 m (n=8, median 270 m/6min). On final assessment, maximum walking distance had significantly improved (range 41 m/6min –600 m/6min, median 336m/6min, p<0,05). Although some patients showed markedly improved motor function, this did not affect the group-related GMFM-scores.

Discussion: A daily, brief locomotor training on a treadmill without body weight support is practicable in children with CP and limited walking capacities. Avoiding partial body weight support facilitates both the training and the implementation of motion patterns in daily life. Whether treadmill training is the first line therapy to improve walking capacities must be elucidated in controlled trials.