This document summarizes research on the effectiveness of body weight supported treadmill training (BWSTT) compared to treadmill training alone for improving gait and endurance in children with cerebral palsy. It finds that BWSTT may be more effective, especially for children with more severe impairments in levels IV and V on the Gross Motor Function Classification Scale. BWSTT can improve stride length, step length, walking speed and endurance. Treadmill training alone also provides benefits like increased walking speed and endurance but BWSTT may provide additional improvements in gait mechanics.

1. RESEARCH POSTER PRESENTATION DESIGN © 2011
www.PosterPresentations.com
Is body weight supported treadmill training more effective than treadmill training at
improving gait efficiency and endurance in children with Cerebral Palsy?
Children with Cerebral Palsy have many motor deficits
that lead to problems with ambulation.
Deviations in normalized gait include:
- Reduced walking speed
- Endurance
- Decreased step and stride length
- Decreased speed
- Decreased toe clearance
- Reduced coordination of movement
All affect the ability of a child with CP to ambulate
independently and efficiency in home and community
environments.
Outcome measures used to evaluate:
-10 m walk test
-6 min and 10 min walk tests
-Gross Motor Function Measure-88
What defines Cerebral Palsy?
Body-Weight Supported Treadmill
Training
Treadmill Training
Clinical Relevance
References
• A randomized control trial comparing the effects of
body-weight supported treadmill training directly to
treadmill training in individuals with cerebral palsy.
• Muscle activity in the trunk and lower extremity
during treadmill training verses over ground walking.
• Muscle activity in the trunk and lower extremity
during body-weight supported treadmill training verses
over ground walking.
• Research dividing data collection into individual
GMFCS levels I-V to determine best practice methods
for this patient population.
1. Chrysagis N, Skordilis EK, Stavrou N, Grammatopoulou E,
Koutsouki D. The effect of treadmill training on gross motor
function and walking speed in ambulatory adolescents with
cerebral palsy: a randomized controlled trial. Am J Phys Med
Rehabil. 2012;91(9):747-60.
2. Grecco LA, Zanon N, Sampaio LM, Oliveira CS. A comparison of
treadmill training and overground walking in ambulant children
with cerebral palsy: randomized controlled clinical trial. Clin
Rehabil. 2013
3. Kurz MJ, Stuberg W, Dejong SL. Body weight supported treadmill
training improves the regularity of the stepping kinematics in
children with cerebral palsy. Dev Neurorehabil. 2011;14(2):87-93.
4. Molina-rueda F, Aguila-maturana AM, Molina-rueda MJ,
Miangolarra-page JC. [Treadmill training with or without partial
body weight support in children with cerebral palsy: systematic
review and meta-analysis]. Rev Neurol. 2010;51(3):135-45.
5. 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.
6. 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.
Lauren Rouse, Laura Stigler
Department of Physical Therapy Bellarmine University, Louisville, KY
Future Research
Cerebral Palsy is a non-progressive lesion to the brain
resulting from damage to an immature brain before,
during, or soon after birth. Damage results in physical
and cognitive deficits 1,4. Level of impairment and
function is defined by the Gross Motor Functional
Classification Scale, levels I-V, levels III-V being most
severely impaired.
http://www.jumpstartpediatrictherapy.com/?attachment_id=1492
Top reasons why body-weight supported treadmill
training should be used:
1. Children with GMFCS levels IV and V may
particularly benefit from body-weight supported
treadmill training for improvements in gait
kinematics and endurance3,4,5,6.
2. Gradual training process that is active, repetitive and
task specific to facilitate attainment of a more
normalized gait pattern in children with CP3,4,5,6.
3. More effective than over ground training alone in
children with CP5.
4. Improvements in gait efficiency and endurance are a
result of treatment, in children with CP3,4,5,6.
Top reasons why treadmill training should be used:
1. Treadmill training is a task specific approach to
improve gait in children with CP1,2.
2. Improvements in gait efficiency and endurance are
results of treatment, in children with CP1,2.
How should Physical Therapists apply this
information?
•Body weight supported treadmill training may be more
effective than treadmill training alone at improving gait
mechanics and endurance in children with GMFCS
levels IV and V2,3.
•Children who are capable of walking without body-
weight support should do so to obtain maximum
benefits2,3.
•Body weight supported treadmill training should be
between 14%-50% body weight supported with gradual
decreases in body weight support by 5% every other
week. Continue with tactile cuing as necessary 3,4.
•Gait speed should gradually be increased with treatment
sessions 30-45min. For up to 12 weeks1-6.
•Treadmill training should be combined with over-
ground training in order to receive maximum benefits
and carryover from treadmill training sessions 2,3,5.
What does the literature say about Body-weight
supported treadmill training?
Body-weight supported treadmill training can be used to
improve:
•Stride length and step length3,4.
•Self-selected walking velocity3,4,6
•Walking endurance4,5,6
•Gross motor function3.
Outcome Measures Utilized :
•10 min walk test
• 6 min walk test
• 10m timed walk
•Gross Motor Functional Measure
What does the literature say about treadmill
training?
Treadmill training can be used to improve:
• Walking velocity 1
• Walking endurance 2
• Gross motor function 1,2
Outcome Measures Utilized:
• 6 min walk test
• Gross Motor Functional Measure
http://www.cahttp://www.nationwidechildrens.org/cerebral-palsy-treatment
rlinscreations.com/
http://www.cpsociety.org.nz/images/GMFCS%202-6%20years.jpg
http://www.abclawcenters.com/blog/2013/11/07/boy-with-cerebral-palsy-
scores-136150