Pediatric Physical Therapy:
Section Information: Abstracts of Platform and Poster Presentations for the 2005 Combined Sections Meeting: Poster Presentations
Rocky Mountain University of Health Professions, Provo, UT, USA (Dannemiller)
Physical Therapy Program, University of Colorado Health Sciences Center, Denver, CO, USA (Heriza)
Occupational Therapy Program, University of New Mexico School of Medicine, Albuquerque, NM, USA (Burtner)
Physical Therapy Department, Mary Bridge Children’s Health Center, Tacoma, WA, USA (Gutierrez)
PURPOSE/HYPOTHESIS: The purpose of this study was to document feasibility, and motor and participation outcomes for young children with cerebral palsy (CP) who received parent-administered partial weight bearing treadmill training (PWBTT).
NUMBER OF SUBJECTS: Three nonambulatory children under the age of 3, participated in this single-subject, multiple baseline study. All children had quadriplegic CP, one was Level III and 2 were Level IV on the Gross Motor Function Classification System (GMFCS).
MATERIALS/METHODS: Parents were trained to administer PWBTT 5 days/wk for 8min/day. Participants received 2, 3, or 4 months of PWBTT. Study duration was 6 months including baseline phase, intervention phase, and follow-up probe. Measured outcomes included: 1) % alternating and parallel steps, 2) Supported Walker Ambulation Performance Scale (SWAPS) scores, 3) the Gross Motor Function Measure (88 and 66) scores, and 4) a participation questionnaire.
RESULTS: Parents of the 3 participants averaged 92.3% of the expected minutes of treadmill training. One child had significant changes in alternating and parallel steps on the treadmill and a significant increase in SWAPS scores. All participants made greater changes on GMFM-88 scores for a 6-month period, compared to published data for children of similar ages and GMFCS levels. One participant made greater change on the GMFM-66, compared to published data for children of a similar age and GMFCS level. Two of the 3 families reported a moderate change in their child’s participation in their family and community.
CONCLUSIONS: Although outcomes varied for the individual children, parent-administered PWBTT may be a feasible intervention to promote improvements in motor outcomes for children with quadriplegic cerebral palsy.
CLINICAL RELEVANCE: This study may contribute to the body of literature for clinical decision-making about the use of PWBTT with young children with CP. Parents were able to carry out a prescribed PWBTT program. A treadmill speed of 0.6 to 1.0mph, body weight support of 10–40%, frequency of 8 min/day, 5 days/wk and 2 mo duration were appropriate for the population of children in this study. The child who benefited the most from the PWBTT intervention in this study had mild spasticity, a preferred mobility pattern of supported walking, and parents who made detailed observations about the intervention they were performing.