Effectiveness of Gait Training Using Dynamic Bodyweight Support System on Locomotor Abilities of Ambulatory Children With Different Neural Disorders Gait training in CP children using DBWSS
International Clinical Neuroscience Journal,
Vol. 10 No. 1 (2023),
15 January 2023
,
Page e14
Abstract
Background: In this study, we evaluated the efficacy of dynamic bodyweight-supported training on the gait quality of children with different neural disorders.
Methods: Seventeen ambulatory children, aged 3 to 11 years, experiencing gait limitations, were selected to participate in the designed gait training program. Each child participated in 10 practice sessions held three days a week, with each training session using the dynamic body weight support system, comprising three stages, and lasting 20 minutes. Clinical assessments were conducted using four functional tests: “Five Time Sit to Stand Test (FSST)”, “Modified Time Up and Go (MTUG)”, “Time Up and Down Stairs (TUDS)”, and “Pediatric Berg Balance Scale” (BBS).
Results: Statistical tests demonstrated a significant increase in the post-values of the BBS after gait training. Notably, children with higher relative cognitive abilities showed more improvement. Additionally, there was a significant enhancement in the assigned score for the level of independence. As all participants had received conventional physical therapies for more than three years, reaching their maximum obtainable improvements with conventional training methods, the observed improvements could be attributed to the designed training protocol even without a control group.
Conclusion: Designed gait training protocol using a dynamic weight support system proved effective in enhancing balance, improving gait quality, and increasing the level of independence during performing functional tests in ambulatory children suffering from different locomotor disabilities.
- gait, child, walk, postural balance, rehabilitation
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References
Shideler BL, Bulea TC, Chen J, Stanley CJ, Gravunder AJ, Damiano DL. Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension. J Neuroeng Rehabil. 2020;17(1):121. doi: 10.1186/s12984-020-00738-7.
Kenyon LK, Westman M, Hefferan A, McCrary PPD, Baker B. A home-based body weight supported treadmill training program for children with cerebral palsy: a case series. Physiother Theory Pract. 2017;33(7):576-85. doi: 10.1080/09593985.2017.1325956.
Singleton C, Jones H, Maycock L. Functional electrical stimulation (FES) for children and young people with cerebral palsy. Paediatr Child Health. 2019;29(11):498-502. doi: 10.1016/j.paed.2019.07.015.
Zhu F, Kern M, Fowkes E, Afzal T, Contreras-Vidal JL, Francisco GE, et al. Effects of an exoskeleton-assisted gait training on post-stroke lower-limb muscle coordination. J Neural Eng. 2021;18(4). doi: 10.1088/1741-2552/abf0d5.
Mukhopadhyay R, Mahadevappa M, Lenka PK, Biswas A. Effect of FES in rehabilitation of cerebral palsy children by analysis of surface EMG in tibialis anterior muscle. In: 2014 IEEE 19th International Functional Electrical Stimulation Society Annual Conference (IFESS). Kuala Lumpur, Malaysia: IEEE; 2014. p. 1-5. doi: 10.1109/ifess.2014.7036755.
del-Ama AJ, Gil-Agudo Á, Bravo-Esteban E, Pérez-Nombela S, Pons JL, Moreno JC. Hybrid therapy of walking with Kinesis overground robot for persons with incomplete spinal cord injury: a feasibility study. Rob Auton Syst. 2015;73:44-58. doi: 10.1016/j.robot.2014.10.014.
Gama GL, Celestino ML, Barela JA, Forrester L, Whitall J, Barela AM. Effects of gait training with body weight support on a treadmill versus overground in individuals with stroke. Arch Phys Med Rehabil. 2017;98(4):738-45. doi: 10.1016/j. apmr.2016.11.022.
Ganesan M, Sathyaprabha TN, Pal PK, Gupta A. Partial body weight-supported treadmill training in patients with Parkinson disease: impact on gait and clinical manifestation. Arch Phys Med Rehabil. 2015;96(9):1557-65. doi: 10.1016/j. apmr.2015.05.007.
Willoughby KL, Dodd KJ, Shields N. A systematic review of the effectiveness of treadmill training for children with cerebral palsy. Disabil Rehabil. 2009;31(24):1971-9. doi: 10.3109/09638280902874204.
Lowe L, McMillan AG, Yates C. Body weight support treadmill training for children with developmental delay who are ambulatory. Pediatr Phys Ther. 2015;27(4):386-94. doi: 10.1097/pep.0000000000000172.
Provost B, Dieruf K, Burtner PA, Phillips JP, Bernitsky- Beddingfield A, Sullivan KJ, et al. Endurance and gait in children with cerebral palsy after intensive body weight-supported treadmill training. Pediatr Phys Ther. 2007;19(1):2- 10. doi: 10.1097/01.pep.0000249418.25913.a3.
Flores MB, Da Silva CP. Trunk control and gross motor outcomes after body weight supported treadmill training in young children with severe cerebral palsy: a non-experimental case series. Dev Neurorehabil. 2019;22(7):499-503. doi: 10.1080/17518423.2018.1527862.
Mattern-Baxter K. Effects of partial body weight supported treadmill training on children with cerebral palsy. Pediatr Phys Ther. 2009;21(1):12-22. doi: 10.1097/ PEP.0b013e318196ef42.
Su IY, Chung KK, Chow DH. Treadmill training with partial body weight support compared with conventional gait training for low-functioning children and adolescents with nonspastic cerebral palsy: a two-period crossover study. Prosthet Orthot Int. 2013;37(6):445-53. doi: 10.1177/0309364613476532.
Willoughby KL, Dodd KJ, Shields N, Foley S. Efficacy of partial body weight-supported treadmill training compared with overground walking practice for children with cerebral palsy: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(3):333-9. doi: 10.1016/j.apmr.2009.10.029.
Apte S, Plooij M, Vallery H. Influence of body weight unloading on human gait characteristics: a systematic review. J Neuroeng Rehabil. 2018;15(1):53. doi: 10.1186/s12984- 018-0380-0.
van Hedel HJA, Rosselli I, Baumgartner-Ricklin S. Clinical utility of the over-ground bodyweight-supporting walking system Andago in children and youths with gait impairments. J Neuroeng Rehabil. 2021;18(1):29. doi: 10.1186/s12984- 021-00827-1.
Mutlu A, Krosschell K, Spira DG. Treadmill training with partial body-weight support in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2009;51(4):268- 75. doi: 10.1111/j.1469-8749.2008.03221.x.
Kawasaki S, Ohata K, Yoshida T, Yokoyama A, Yamada S. Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial. J Neuroeng Rehabil. 2020;17(1):87. doi: 10.1186/ s12984-020-00712-3.
Pignolo L, Basta G, Carozzo S, Bilotta M, Todaro MR, Serra S, et al. A body-weight-supported visual feedback system for gait recovering in stroke patients: a randomized controlled study. Gait Posture. 2020;82:287-93. doi: 10.1016/j. gaitpost.2020.09.020.
Begnoche DM, Pitetti KH. Effects of traditional treatment and partial body weight treadmill training on the motor skills of children with spastic cerebral palsy. A pilot study. Pediatr Phys Ther. 2007;19(1):11-9. doi: 10.1097/01. pep.0000250023.06672.b6.
Huber JP, Sawaki L. Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study. J Neuroeng Rehabil. 2020;17(1):157. doi: 10.1186/s12984-020-00791-2.
Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2012;26(7):664-71. doi: 10.1177/0269215511426889.
Verbecque E, Vereeck L, Boudewyns A, Van de Heyning P, Hallemans A. A modified version of the timed up and go test for children who are preschoolers. Pediatr Phys Ther. 2016;28(4):409-15. doi: 10.1097/pep.0000000000000293.
Chrysagis N, Skordilis EK, Tsiganos G, Koutsouki D. Validity evidence of the Lateral Step Up (LSU) test for adolescents with spastic cerebral palsy. Disabil Rehabil. 2013;35(11):875-80. doi: 10.3109/09638288.2012.711896.
Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther. 2003;15(2):114-28. doi: 10.1097/01. pep.0000068117.48023.18.
Shumway-Cook A, Woollacott MH. Motor Control: Translating Research into Clinical Practice. Lippincott Williams & Wilkins; 2007.
Goh MSL, Looi DSH, Goh JL, Sultana R, Goh SSM, Lee JH, et al. The impact of traumatic brain injury on neurocognitive outcomes in children: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2021;92(8):847-53. doi: 10.1136/jnnp-2020-325066.
Hanlon RE. Motor learning following unilateral stroke. Arch Phys Med Rehabil. 1996;77(8):811-5. doi: 10.1016/s0003- 9993(96)90262-2.
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