Katrin Mattern-Baxter

Effects of Intensive Locomotor Treadmill Training on Young Children with Cerebral Palsy

Purpose: To examine whether an intensive, short-term locomotor treadmill training program helps children with cerebral palsy (CP) younger than 4 years of age improve their gross motor skills related to ambulation, walking speed, and endurance. Methods: Six children with cerebral palsy, ages 2.5 to 3.9 years, participated in treadmill training 3 times per week for 1-hour sessions consisting of 2 individualized treadmill walks, for 4 weeks, and were tested before and after the intervention and at a 1-month follow-up. The outcome measures included the Gross Motor Function Measure-66, the Pediatric Evaluation of Disability Inventory, a timed 10-m walk test, and a 6-minute walk test. Results: Significant differences were found in the Gross Motor Function Measure-66 Dimensions D and E, the Pediatric Evaluation of Disability Inventory Mobility Scales, over-ground walking speed, and walking distance. Conclusions: The results of this study provide preliminary evidence that children with CP younger than 4 years of age can improve their gross motor function, walking speed, and walking endurance after intensive locomotor treadmill training.

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

Purpose: The purpose of this literature review was to investigate the effects of partial body weight supported treadmill training (BWSTT) on gross motor function, balance, gait speed, and endurance in children with cerebral palsy (CP). Summary of Key Points: Larger numbers of preschool and school-aged children have been studied compared with infants and toddlers. More evidence exists regarding the efficacy of BWSTT on endurance, gait speed, and gross motor function related to ambulation than on balance in children with CP. Longer and more intense BWSTT protocols may lead to better results. Statement of Conclusions: BWSTT has not been studied extensively in children with CP. Current evidence suggests that intensive and prolonged BWSTT may be a safe, effective, and beneficial treatment intervention for the attainment of walking, improvement of gait speed, and improvement of endurance for children with different types and degrees of CP.

Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial.

OBJECTIVE To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP). DESIGN Quasi-randomized controlled trial. SETTING Homes of the participants. PARTICIPANTS Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up. INTERVENTIONS All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the childrens parents with weekly supervision by a physical therapist. MAIN OUTCOME MEASURES Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively. RESULTS There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04). CONCLUSIONS Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP.

Effects of a Group-Based Treadmill Program on Children With Neurodevelopmental Impairment Who Are Not Yet Ambulating.

Purpose: To examine the effects of a group-based treadmill program on gross motor skills related to walking and the amount of support needed for ambulation in children with neuromotor impairment who are not yet walking. Methods: Twelve children (mean age, 30.4 months; standard deviation, 7.9) participated in the program twice per week for 14 weeks. The Gross Motor Function Measure-88 Dimensions D and E (GMFM-88 D/E), the Functional Mobility Scale (FMS), the timed 10-m walk test, and the Pediatric Evaluation of Disability Inventory Mobility Scale (PEDI) were administered before and at the conclusion of the program. Data were analyzed using paired the t test and Wilcoxon matched-pairs signed rank test. Results: Statistically significant improvements were found between pre- and posttests in the GMFM-88 D (P = .0005) and E (P = .001), in FMS scores (P = .039), and the PEDI (P = .001). Conclusions: A group-based treadmill program leads to positive changes in walking ability in children with neuromotor impairment.

Intensive, functional training leads to optimal outcomes in a young woman post brain stem hemorrhage due to cerebral cavernous malformation

ABSTRACT Purpose Cerebral cavernous malformations (CCMs) can cause intracranial hemorrhages and account for 5–15% of all cerebral vascular malformations. The purpose of this retrospective case report is to describe the unusual motor recovery of a young woman following a large hemorrhage of a previously unknown brainstem CCM, otherwise not reported in the literature. Case Description: The patient was a 29-year-old female who presented with severe hemiparesis on the left 6 weeks after a first-ever hemorrhage. She had demonstrated minimal improvement in her motor recovery to date, was dependent on a walker for ambulation, and had no distal left upper extremity function. An intensive evidence-based plan of care over 6 weeks included progressive task-specific strengthening, treadmill training, and dynamic balance training. Outcomes: The patient achieved complete motor recovery, indicated by improvement from 23/66 to 64/66 in the Fugl-Meyer Upper Extremity Subscale score and from 12/30 to 30/30 in the Functional Gait Assessment. She returned to independent ambulation with functional gait speeds and kinematics. Discussion: This case report demonstrates an unusual clinical course of unexpected full recovery in a young woman after a large brainstem CCM after an intensive 6-week course of physical therapy. Other patients with a similar presentation after CCM may benefit from an intensive plan of care. Clinicians should be aware of the possibility of unusual recovery in this population as not to limit expectations for recovery.