Objective: To examine effects of treadmill training on gross motor skills, ability to walk up-down stairs and on level ground, maximum voluntary isometric contraction force (MVICF) of lower leg muscles, and spasticity in children with cerebral palsy.

Background: A treadmill is a device that plays a huge role in therapeutic exercise, especially gait training. [1] Children with spastic cerebral palsy (CP) have difficulty in walking because of abnormal motor control. Treadmill training would have extensively benefit for children with CP. [2-3] However, in Thailand, there is a limitation of the accessibility to the treadmill and efficacy program for treadmill training.

Method: This study was a single-subject design (withdrawal designs or A-B-A) with a control group. Two children with spastic CP (age 7 and 12 years old) participated in the control group which had only received regular physical therapy session. Another 2 children with CP (aged 6 and 16 years old) participated in an intervention group which had received both regular physical therapy session and treadmill training. The treadmill training was 0-10% body weight with gradually increasing max velocity for 2.5 minutes for 3 times per week for 6 weeks. The outcome measures were Gross motor function measure (GMFM), Timed up and down stairs (TUDS), MVICF using hand-held dynamometer, energy expenditure index (EEI), and level of spasticity using modified Ashworth scale (MAS). These outcome measures were tested at based line phase for 3 times per week for 2 weeks (a total of 6 data points), intervention phase once a week for 6 weeks (a total of 6 data points), and withdrawal phase for 3 times per week for 2 weeks (a total of 6 data points).

Results: In the intervention group, gross motor skills were significantly improved by 6.74-14.35% and spasticity of the lower extremity was significantly decreased after treadmill training.

Conclusion: The effect of 2.5 minutes for 3 times per week for 6 weeks with low support treadmill training program did improve gross motor skills and spasticity of lower extremity in children with spastic CP. However, clinical implications of this study may be limited in the generalizability because of the single-subject design.

References: [1] Guzik, A., Drużbicki, M., & Wolan-Nieroda, A. (2018). Assessment of two gait training models: conventional physical therapy and treadmill exercise, in terms of their effectiveness after stroke. Hippokratia, 22(2), 51–59. [2] Rodrigues De Sousa, R, Figueiredo, P., Teixeira, C., Venturi, L., & Brandao, M. (2017). The effects of treadmill training in children with cerebral palsy: a systematic review. Developmental Medicine & Child Neurology, 59(S3), 109-110. [3] Willoughby, K. L., Dodd, K. J., & Shields, N. (2009). A systematic review of the effectiveness of treadmill training for children with cerebral palsy. Disabil Rehabil, 31(24), 1971-1979.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-maximum-speed-treadmill-training-on-walking-capability-in-children-with-cerebral-palsy/