Effects of Partial Body Weight Supported Treadmill Training
on Children with Cerebral Palsy

Katin Mattern-Baxter, PT, DPT, PCS Department of Physical Therapy,
University of the Pacific, Stockton, CA Journal of Pediatric Physical Therapy, 21:12-22

Summary by Sonya Seif

The authors of this literature review assemble and present the methods and results of recent relevant research in an attempt to investigate the effects of body weight supported treadmill training (BWSTT) on gross motor function, balance, gait speed, and endurance in children with CP.  They focus on ten articles and case studies published between 1997 and 2008.  While recognizing that the question needs to be more extensively studied, they draw the conclusion that longer and more intense BWSTT protocols may be safe, effective, and beneficial in the attainment of walking, improvement of gait speed and endurance with varying types and degrees of CP.   The studies compiled in this review, however, report mixed results and more school-aged children have been studied compared to toddlers and infants with such small sample sizes that it is difficult to support definite conclusions.  

The ten studies compared here included one clinical controlled trial (Dodd and Foley), six small cohort studies (Begnoche and Pitetti, Cherng et al, Provost et al, Richards, et al, Schindl et al, and Unnithan et al), two case reports (Bodkin et al, and McNevin et al) and 1 case study (Day et al).  Not only do the authors assemble and present the results of each of these studies, but they rank them based on significance and are able to score the different studies based on their relative levels of evidence per the Sackett, 10 point (4C to 1A) system and the Evans 5 point (poor to excellent) system.  These rankings were given based on sample size, control over parameters, and reported results.  Unfortunately, the varying durations, degrees of difficulty, and ages of the children make the ten different studies extremely difficult to compare.  The children ranged in age from 5 months to 18 years old and the therapy regimes varied from twice over 1 week to 6 times in 2 weeks, to 3 times a week for 4 months.  Success was measured with a variety of tools, including the Functional Ambulation Categories (FAC), the Gross Motor Function Measure (GMFM), the Supported Walkers Ambulation Performance Scale (SWAPS), and the Energy Expenditure Index (EEI).

General trends of improvement were seen in the different studies, though statistical significance was rarely shown due to such small and varied sample populations.  It was seen in the studies with longer, more frequent, and more intense treatment regimes, that the children improved more.  For complete information on the results of each of the studies reported on in this review, please see the original article.  The authors present the treatment plan, the studied group of children, the results, and the testing methods quite succinctly for each of the ten studies.