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Published on: August 9, 2024
Short-term Therapeutic Effects of Antigravity Treadmill Training on Brain Activities and Walking Capacity in Children
Meghdad Ashtiyani1, Parmida Moradi Birgani2, Maryam Soleimani3
1Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Anti-gravity treadmill training significantly improved motor cortex activation and clinical outcomes in children with cerebral palsy (CP). This therapy offers a promising approach for enhancing gait and balance in pediatric CP patients.
Area of Science:
- Neuroscience
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a leading cause of childhood motor disability, stemming from brain damage.
- Effective CP treatment requires interventions that promote functional brain activity alongside clinical improvements.
Purpose of the Study:
- To investigate the effects of anti-gravity treadmill training on brain functional activity and motor performance in children with spastic hemiplegic CP.
- To compare the efficacy of anti-gravity treadmill training with traditional occupational therapy.
Main Methods:
- 14 children with spastic hemiplegic CP were randomized into a training group (anti-gravity treadmill) and a control group (occupational therapy).
- Functional magnetic resonance imaging (fMRI) assessed brain activation during passive ankle and knee movements before and after the 8-week intervention.
- Walking capacity was evaluated using timed-up-and-go, 10-m, and 6-m walking tests.
Main Results:
- Anti-gravity treadmill training led to greater motor cortex activation, particularly in the primary motor cortex, precentral gyrus, and corpus callosum, for ankle movements compared to knee movements.
- The training group showed 16.1% more active voxels than the control group.
- Clinical outcome measures, including walking capacity, improved more than twice as much in the training group compared to the control group.
Conclusions:
- Anti-gravity treadmill training demonstrates potential as an effective therapeutic intervention for children with CP.
- This training approach may significantly improve gait and balance impairments in pediatric CP patients.
Introduction:
Cerebral palsy (CP) is one of the most common causes of motor disability in childhood. Since CP is a corollary of brain damage, persistent treatment should accompany alterations in brain functional activity in line with clinical improvements.
Methods:
A total of 14 children with spastic hemiplegic CP were randomly divided into 2 groups. The training group (8.5 years) underwent 45 min anti-gravity treadmill training sessions 3 times/week for 8 weeks, while the control group (8.2 years) received the same amount of occupational therapy (OT). Functional magnetic resonance imaging (fMRI) was conducted to quantify brain activation during the performance of passive tasks, including ankle plantarflexion to dorsiflexion and knee flexion to extension over the range of motion. Walking capacity was assessed using the timed-up-and-go, 10-m, and 6-m walking tests. All evaluations were performed before and after training and compared between the two groups.
Results:
This study could detect the signatures of ankle and knee passive movement tasks in the fMRI and characterize them in terms of activated voxels. The pre-post activation changes following the completion of the training course showed that the elicited motor cortex activation was greater for the ankle than the knee tasks. For the ankle, the primary motor cortex, precentral gyrus, and corpus callosum showed significant enhancement in most study participants. The results indicated 16.1% more active voxels in the study than control groups. Similarly, clinical outcome measures improved over twice as much in this group.
Conclusion:
Anti-gravity treadmill training could be a potentially effective therapeutic intervention for improving gait and balance impairments in children with CP.
