Gait characteristics of children with cerebral palsy as they walk with body weight unloading on a treadmill and over the ground.
Surface beats support: kids with CP walk differently on treadmills than on floors, even when body-weight support stays the same.
01Research in Context
What this study did
L et al. watched six kids with cerebral palsy walk three ways. Each child walked on a treadmill with body-weight support. Then they walked over ground with the same support. Last, they walked over ground with no support.
Motion cameras tracked hip, knee, and ankle angles. The team compared steps across the three setups.
What they found
Ground surface changed gait more than how much weight was unloaded. Treadmill steps were shorter and faster. Over-ground steps were longer and more varied.
Support level mattered less. Whether the child carried 0 %, 10 %, or 20 % of body weight, the pattern stayed the same for each surface.
How this fits with other research
DeRoma et al. (2004) saw big gains after two months of daily treadmill work in girls with Rett syndrome. Their study says treadmill training helps. L et al. agree, but warn that treadmill gait is not the same as floor gait.
Ferreira et al. (2014) used the Gait Profile Score to show surgery improves ankle motion in CP. L et al. add that even without surgery, simply switching from treadmill to floor can shift ankle angles.
Chen et al. (2013) found stronger quads predict motor gains. L et al. hint that surface choice might be another easy lever to pull.
Why it matters
If you use treadmill training, do not assume the child will walk the same way at home or at school. Check gait on both surfaces. When you fade support, focus on where they walk, not just how much weight they carry.
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Film 10 steps on the treadmill, then 10 steps on the hallway floor; compare step length and speed before your next support adjustment.
02At a glance
03Original abstract
Body weight support (BWS) has become a typical strategy for gait training, in special with children with cerebral palsy (CP). Although several findings have been reported in the literature, it remains uncertain how different types of surfaces and gradual amount of BWS can facilitate the mobility of children with CP. The aim of this study was to investigate gait kinematic parameters of children with CP by manipulating BWS and two different types of ground surfaces. Ten children (7.7 ± 2.1 years old) diagnosed with spastic CP and GMFCS classification between levels II and IV were asked to walk on a treadmill and over the ground. In both conditions, BWS was manipulated to minimize gravitational effects and spatial-temporal gait parameters and lower limb joints were analyzed. The results revealed that the type of ground surface causes greater impact on the gait pattern of children with CP as compared to body weight unloading. This finding may provide new insights into the behavioral heterogeneity of children with CP, and offers critical information to be considered on interventional programs specifically designed to improve mobility on this population.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.09.002