Project Description:
Three research projects designed to study the effectiveness of using a treadmill with partial body-support training program to develop or improve walking skills in children with developmental disabilities were completed. Thirty children diagnosed with a developmental disability, primarily cerebral palsy, were recruited with 10 in each of three study groups. Group 1 children demonstrated a “crouch gaitâ€. Children in Group 2 were identified by their family as having difficulty walking due to fatigue or who require a significant amount of arm support from an assistive device while walking. Children in Group 3 demonstrated moderate to severe mental impairment, were not able to walk independently and were believed to have good potential for independent walking given adequate practice and support. The children were between the ages of three to 18 years
Children in Groups 1 and 2 used a motorized treadmill designed to ensure the safety and to provide the needed therapeutic walking protocol. A partial body weight support system was used to lift a percent of the child’s body weight, provide assurance of balance, and prevent falls. The children in Group 3 did not use the treadmill, but used the support harness to facilitate walking without requiring the support of care givers.
Training on the treadmill with the support harness (Groups 1 & 2) was carried out three times-per-week for 20 minutes sessions. Walking with the support harness alone (Group 3) was carried out twice-per-week for up to a 20 minute session or as tolerated by the child. Twelve weeks of training (total of 24 sessions) was provided for each child. The sessions were provided by a physical therapist assistant under the direction of a licensed physical therapist. Progression of the training program on the treadmill for Groups 1 & 2 was individualized based on capability of the child. A slow enough speed to ensure at least 10 minutes of continuous walking as a starting point with increase in speed and duration to 20 minutes as tolerated.
Walking was assessed in all children by a physical therapist trained in using; 1) the Gross Motor Function Measure (GMFM), dimensions D (standing) and E (walking, running and jumping) and 2) the Supported Walker Ambulation Performance Scale (SWAPS) . The measures were done prior to the training, immediately following the training and one month after completion of the program. Children in Groups 1 & 2 were also evaluated pre and post treadmill walking training in the Motion Analysis Lab. Lab analysis includes computerized 3-D videography with computer software to measure joint angles, the speed of walking, step lengths and cadence. Select children in Group 1 and all children in Group 2 were also tested before and after the treadmill training program with an AeroSport Metabolic Measurement system that measures and quantifies the amount of energy used during walking.
