Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial

Abstract

Objective: To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP).

Design: Quasi-randomized controlled trial.

Setting: Homes of the participants.

Participants: Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up.

Interventions: All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist.

Main outcome measures: Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively.

Results: There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04).

Conclusions: Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP.

Keywords: 10-m walk test; 10MWT; CP; Cerebral palsy; Child; DS; Dim D/E; Dimensions D/E; Down syndrome; FMS; Functional Mobility Scale; GMFCS; GMFM-66; Gait; Gross Motor Function Classification Scale; Gross Motor Function Measure-66; LTT; PDMS-2; PEDI; Peabody Developmental Motor Scales-2; Pediatric Evaluation of Disability Inventory; Rehabilitation; Walking; cerebral palsy; locomotor treadmill training.