Persons with cerebral palsy display improved occipital cortical entrainment after gait training

Prior neuroimaging work has shown that people with cerebral palsy (CP) often have visual processing impairments that impact their motor actions. We evaluated if a physical therapy gait training paradigm that incorporated visuomotor tasks has the potential to improve mobility and result in training-related changes in the entrainment of the occipital cortices of people with CP. People with CP (N = 29; Age = 19.9 ± 7.3 years; Gross Motor Classification Score Levels I-III) underwent 24 gait training sessions and completed a comprehensive battery of clinical assessments to quantify their mobility improvements. Magnetoencephalography (MEG) was used to image the cortical activity induced by viewing a 15 Hz flashing stimulus before and after therapy. Neurotypical controls (N = 34; Age = 23.1 ± 3.7 years) were used to gauge the extent of the cortical aberrations and the direction of treatment effects. The group with CP exhibited significantly weaker neural activity in the occipital cortices relative to the neurotypical controls prior to therapy. However, the strength of this event-related synchronization (ERS) increased following therapy. Furthermore, those with a larger change in the strength of the ERS tended to have the greatest improvements in preferred walking speed after therapy. Gait training paradigms that incorporate visuomotor tasks might have the potential to improve mobility, as well as occipital cortical activity in people with CP.