Repetitive Split-Belt Treadmill Perturbation in Children With Unilateral Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      This study was designed to investigate the effect of repeated split-belt treadmill waking
      practice on gait symmetry, dynamic balance control, and locomotor capacity in adolescents
      with unilateral cerebral palsy (ULCP). Fifty-two children with ULCP were randomly allocated
      to the split-belt treadmill walking (n = 26; undergone split-elt treadmill training or the
      Control group (n =23, received standard rehabilitation program). Both groups were assessed
      for gait symmetry, dynamic balance control, and locomotor capacity pre and post-treatment.
    

Detailed description: 
      Fifty-two children with ULCP were recruited from the Physical Therapy Outpatient Clinic of
      the College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, King Khalid
      Hospital, and a tertiary referral hospital, Al-Kharj, Saudi Arabia. Their age ranged between
      10 and 16 years, were functioning at levels I or II according to the Gross Motor Function
      Classification System, and had spasticity levels 1 or 1+ per the Modified Ashworth Scale.
      Children were excluded if they had fixed deformities, underwent neuromuscular or orthopedic
      surgery in the last 12 months, submitted to BOTOX injection in the past 6 months, had
      attentional neglect, and if they had cardiopulmonary problems that could be exacerbated by
      exercise.

      Outcome measures

        1. Gait-symmetry Indices: Gait symmetry indices (Spatial and temporal) were measured
           through the portable GAITRite system.

        2. Dynamic balance: The directional dynamic limit of stability (forward, backward, paretic,
           and non-paretic) and overall limit of stability were assessed using the Biodex balance
           system.

        3. Locomotor capacity: This was assessed through the 6-minute walk test (6-MWT), the Timed
           Up and Down Stair test (TUDS), and the 10-meter Shuttle Run Test (10mSRT).

      Both groups were trained for one hour, three times a week, for 12 successive weeks. The
      split-belt treadmill walking group performed repetitive split-belt treadmill training with an
      error-augmentation strategy (i.e., exaggeration of the initial step-length asymmetry). The
      control group received the standard rehabilitation program, which comprised advanced balance
      training, and gait training exercises, postural and flexibility exercises, strength training
      exercises.
    

Intervention name(s): Split-belt treadmill training; Standard physical therapy
Intervention type(s): Other; Other
Intervention description(s): Participants in the split-belt walking group (experimental group) performed repeated split-belt treadmill training with an error-augmentation strategy (exaggeration of the initial step-length asymmetry) for 60 minutes, three times per week for 12 successive weeks. The training was conducted under close supervision of a licensed pediatric physical therapist according to safety performance guidelines defined by the American Academy of Pediatrics.; Participants in the control group received the standard physical therapy program. Each session lasted for 60 minutes, repeated three times a week, over 12 consecutive weeks. The program consisted of advanced balance training, gait training, postural and flexibility exercises, and strength training exercises.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, randomized controlled clinical trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment