Treadmill training after surgical removal of a spinal tumor in infancy

Step training on a treadmill is a common intervention for adult and pediatric patients with spinal cord injuries (SCI). Treadmill training has not been used as an intervention for infants and toddlers with SCI before walking onset. This case report describes the intervention and stepping behaviors on a treadmill and overground of a toddler after the surgical removal of a rare spinal tumor resulting in SCI.

The toddler presented with an inability to step on the left, rare stepping on the right, and an apparent lack of sensation in the lower extremities. After spinal tumor excision at 5.5 weeks of age, step training on a treadmill and overground occurred once per week from 15 to 35 months of age in addition to traditional physical therapy.

Independent symmetrical stepping emerged both on and off the treadmill over 20 months. Improvements in the number and pattern of steps occurred with training. Walking speed increased, and milestones important to overground walking developed.

Independent steps developed during the intervention with little motor development of the lower extremities during the first year of life. Furthermore, improvements in stepping alternation, standing, and walking occurred despite no evidence of sensation in the lower extremities.