Journal Club CEU Approval
Contact Hours: 1
AR | FL CE26-803266 | ID
Effects of a supported speed treadmill training exercise program on impairment and function for children with cerebral palsy
JC12Q1
On-demand
$10
On-demand
$10
Webinar Description
Johnston, TE, Watson KS, Ross SA, Gates PE, Vaughan JP, Layer RT, Tucker CA, Engsberg, JR (2011).Effects of a supported speed treadmill training exercise program on impairment and function for children with cerebral palsy. Child Neuro 53:742-50.
Summary by Nechama Karman, PT, MS, PCS
Twenty six children (target n=54) ages 6-13 years of age with spastic cerebral palsy (diplegia, triplegia and quadriplegia) and marginal ambulatory function (gait velocity < 80% age-expected value or GMFCS level III – IV and able to take 8 steps independently with or without an assistive device) were recruited from 3 sites. Children were able to follow multi-step commands, and parents and children needed to be available daily (BID sessions) for a 2-week induction period at their primary data collection site. Children were excluded from the study for medical conditions precluding exercise participation, LE orthopedic surgery within the pervious year, Botox injection within the previous 6 months, selective dorsal rhizotomy within the previous 2 years, baclofen users, flexion contractures at the hip (>30°) or knee (>20°) or ankle (> 15° with knee extended) and for non-spastic CP type (athetoid or mixed CP). Subjects were randomly assigned to the SSTEPS group or to the home exercise group, and participated in a 2-week (weekdays) induction period that included 2 thirty-minute sessions of program establishment and parent training followed by a 10-week intervention period delivered by each child’s parents at home for 30 minutes/day for a total of 12 weeks of daily (weekday) intervention. The BWSTT (n=14) subjects walked at home on a treadmill for 30 minutes, supported by a Kaye suspension walker and with assistance provided by their parents who sat facing the child on a bench positioned over the treadmill belt. During the induction period a decision was made as to whether the child should use orthotic devices during treadmill training and body weight support and speed were adjusted to establish a target BWS of less than 30% and a baseline walking speed (WS) that was closer to normal (adjustments were made for TM use as necessary). Criteria for walking speed or BWS advancement included foot flat or heel-toe gait, initiation of swing phase, knee extension in stance and consistent foot placement. The individualized HEP (n=12) included 30 minutes of exercise daily (weekdays) comprised of exercises that emphasized strength: standing weight bearing exercise, step-ups, squats, progressive resistive exercise (PRE) for upper and lower extremities, core strengthening. Assistance was provided as necessary by the child’s parents, and assistive devices were used as needed during standing exercises. Weekly telephone monitoring by the child’s supervising therapist was used to determine program advancements (walking speed increases for BWSTT subjects increases in number of repetitions or addition of ankle weights for HEP subjects). Parents maintained weekly logs which were used to determine program compliance. 80% compliance was required to participate in data collection and analysis.
CEU Information
Webinar Information
Contact Hours: 1
Price: $10
Instructor: Nechama Karman
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