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Treadmill training with partial body-weight support in children with cerebral palsy: a systematic review
Akmer Mutlu1, Kristin Krosschell, Deborah Gaebler Spira
1Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
Insights
Partial body-weight support treadmill training (PBWSTT) shows limited evidence for improving functional outcomes in children with cerebral palsy (CP). More high-quality research is needed to confirm its benefits.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Physical Therapy
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Partial body-weight support treadmill training (PBWSTT) is an intervention aimed at improving gait and mobility in children with CP.
Purpose of the Study:
- To systematically review the existing literature on the effects of PBWSTT in children with CP.
- To evaluate the impact of PBWSTT on functional outcomes and ambulation attainment.
Main Methods:
- A systematic literature search was conducted from 1950 to July 2007.
- Eight studies on PBWSTT in children with CP were identified and evaluated using established systematic review methodologies.
- The review focused on seven studies involving 41 children.
Main Results:
- Evidence regarding the functional effects of PBWSTT is limited.
- Several studies reported improvements in gross motor function, functional status, walking performance, and gait parameters, but statistical significance was not consistently demonstrated.
- The overall evidence for functional benefits is not statistically significant.
Conclusions:
- The systematic review is limited by a small sample size, heterogeneous participant abilities (Gross Motor Function Classification System levels I-IV), and low trial quality.
- Current evidence does not support the conclusion that PBWSTT leads to improvements in children with CP.
- Further well-designed randomized controlled trials are necessary to determine the efficacy of PBWSTT for children with CP.
Aim:
The aim of this systematic review was to examine the literature on the effects of partial body-weight support treadmill training (PBWSTT) in children with cerebral palsy (CP) on functional outcomes and attainment of ambulation.
Method:
We searched the relevant literature from 1950 to July 2007. We found eight studies on the use of PWSBTT on functional outcomes in children with CP. The methodology to develop systematic reviews of treatment interventions as suggested by the American Academy of Cerebral Palsy and Developmental Medicine and the Critical Review Form-Quantitative Studies Methodological Quality was used to evaluate each article.
Results:
As two of the eight published articles reported on different outcomes of the same study, this review reports on seven studies with a total of 41 children. The evidence for the functional effects is limited. Statistical significance is not demonstrated in several of the studies, despite reported improvements in gross motor function, functional status, walking performance, and gait parameters.
Interpretation:
This systematic review is limited by the small number of participants, the heterogeneous level of abilities of participants from Gross Motor Function Classification System levels I to IV, and the low quality of trials. Because of these limitations, we cannot conclude that PBWSTT results in improvements for children with CP. Additional studies and well-established randomized controlled (or clinical) trials are clearly needed before determining the benefits and efficacy that would support continued use of this intervention in the clinical setting.
