A comparison of treadmill training and overground walking in ambulant children with cerebral palsy: randomized controlled clinical trial
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Luanda André Collange Grecco1, Nelci Zanon, Luciana Maria Malosá Sampaio
1Rehabilitation Sciences, Universyt Nine July, São Paulo, SP, Brazil. luandagrecco@uninove.br
Insights
Treadmill training significantly improved motor skills in children with cerebral palsy compared to overground walking. This intervention enhanced functional mobility, gross motor function, and balance more effectively.
Area of Science:
- Pediatrics
- Neurology
- Physical Therapy
Background:
- Cerebral palsy (CP) affects motor skills in children.
- Therapeutic interventions aim to improve functional mobility and gross motor function in children with CP.
- Treadmill training and overground walking are common physical therapy approaches.
Purpose of the Study:
- To compare the effectiveness of treadmill training versus overground walking on motor skills in children with cerebral palsy.
- To evaluate the impact of these interventions on functional mobility, performance, gross motor function, and balance.
Main Methods:
- A randomized controlled clinical trial was conducted in physical therapy clinics.
- Thirty-six children with cerebral palsy (Gross Motor Functional Classification System levels I-III) were divided into two groups.
- The experimental group underwent treadmill training without partial weight support, while the control group performed overground walking for seven weeks, followed by a four-week follow-up.
Main Results:
- Both groups showed improvements in the 6-minute walk test, timed up-and-go test, Pediatric Evaluation Disability Inventory, Gross Motor Function Measure-88, and Berg Balance Scale.
- The treadmill training group demonstrated significantly greater improvements in all measured outcomes compared to the overground walking group.
- These superior effects were observed both immediately after treatment and during the follow-up period.
Conclusions:
- Treadmill training without partial weight support is more effective than overground walking for enhancing functional mobility, functional performance, gross motor function, and functional balance in children with cerebral palsy.
- This study highlights the potential of treadmill training as a superior therapeutic modality for improving motor outcomes in this population.
- Further research may explore optimal parameters for treadmill training in children with varying levels of cerebral palsy severity.
Objective:
Compare the effects of treadmill training and training with overground walking (both without partial weight support) on motor skills in children with cerebral palsy.
Design:
Randomized controlled clinical trial.
Setting:
Physical therapy clinics.
Subjects:
Thirty-six children with cerebral palsy (levels I-III of the Gross Motor Functional Classification System) randomly divided into two intervention groups.
Interventions:
Experimental group (17 children) submitted to treadmill training without partial weight support. Overground walking group (18 children) submitted to gait training on a fixed surface (ground). Training was performed for seven consecutive weeks (two sessions per week), with four subsequent weeks of follow-up.
Results:
Both groups demonstrated improvements on the 6-minute walk test (experimental group from 227.4 SD 49.4 to 377.2 SD 93.0; overground walking group from 222.6 SD 42.6 to 268.0 SD 45.0), timed up-and-go test (experimental group from 14.3 SD 2.9 to 7.8 SD 2.2; overground walking group from 12.8 SD 2.2 to 10.5 SD 2.5), Pediatric Evaluation Disability Inventory (experimental group from 128.0 SD 19.9 to 139.0 SD 18.4; overground walking group from 120.8 SD 19.0 to 125.8 SD 12.2), Gross Motor Function Measure-88 (experimental group from 81.6 SD 8.7 to 93.0 SD 5.7; overground walking group from 77.3 SD 7.0 to 80.8 SD 7.2), Berg Balance Scale (experimental group from 34.9 SD 8.5 to 46.7 SD 7.6; overground walking group from 31.9 SD 7.0 to 35.7 SD 6.8) after treatment. The experimental group demonstrated greater improvements than the overground walking group both after treatment and during follow up (p < 0.05).
Conclusion:
Treadmill training proved more effective than training with overground walking regarding functional mobility, functional performance, gross motor function and functional balance in children with cerebral palsy.
