CLINICAL BOTTOM LINE
“How could I apply this information?”
Ambulation is often a priority of parents of children with a neurodevelopmental impairment. When conducting treadmill training in the clinic, therapists need to challenge patients to increase treadmill speed and decrease the amount of upper extremity support on hand rails. This study showed statistically significant improvements in walking by implementing this type of treadmill training over a relatively short 14-week period. Group-based treadmill training was delivered at a university by DPT students and parents under the supervision of a trained therapist. This protocol offers an alternative to direct intervention by a physical therapist alone and, therefore, shows how clinical resources may be redistributed to maximize therapeutic benefit. This model would work well for patients who do not have access to pediatric treadmills at home and for communities where therapists are in short supply, but where support staff members such as students, therapy aides, or assistants are available. This may not work in all settings as many therapists do not have access to the number of pediatric treadmills or support staff necessary for group-based therapy.
“What should I be mindful about when applying this information?”
With 12 subjects, the generalizability of this study's findings is limited because the sample is unlikely to be a thorough representation of the heterogeneous population being analyzed. Although further research is needed, the results of this study are meaningful as they support a group-based therapy program, promote increased parental involvement with therapeutic activities, and stress the importance of high repetition in optimizing motor outcomes. Parents described the program as being “valuable,” which implied they were accepting of ancillary staff providing therapeutic interventions. In doing so, they seemed to dispel the notion that therapists are the only people who can help a child. It also implied that a motivating group therapy environment may be just as important as a therapist-driven model of therapy.
Julia Jarrin, PT, MPT, ATP
Elissa Rynearson, PT, DPT, ATP
Huntington Beach, California