Intensive Home-based Treadmill Training and Walking Attainment in Young Children With Cerebral Palsy

The purpose of this study is to determine optimal parameters for dosing home-based treadmill
training by comparing high-intensity (5 days/week, twice daily for 10-20 min for 6 weeks) to
low-intensity (2 days/week, once daily for 10-20 minutes for 6 weeks) treadmill training; and
to compare the effects of high- versus low-intensity treadmill training on walking attainment
and overall walking activity in young children with cerebral palsy.

Hypotheses

- A more intensive protocol of treadmill training will increase walking onset in young
children with CP.

- A more intensive protocol of treadmill training will increase overall walking activity
in young children with CP.

Specific Aims

- To determine optimal parameters for dosing home-based treadmill training by comparing
high-intensity to low-intensity home-based treadmill training.

- To compare the effects of high- versus low-intensity treadmill training on walking onset
and overall walking activity.

Study design •Prospective randomized controlled trial

Study population

•Two groups of 12 children with CP under the age of 3 years and are not walking yet will
receive either home-based high-intensity treadmill training or low-intensity treadmill
training. The children will be assessed before, immediately after, at 1-month and at 4-months
following the intervention via standardized outcome measures.

Inclusion Criteria:

- Signs of walking readiness as demonstrated by the ability to sit for 30 seconds when
placed and to take 5 to 7 steps when supported at the trunk or arms.

- Because young children often are not formally diagnosed with CP until 2 years of age,
we will include children

- who show bilateral impairment (i.e. diplegia and quadriplegia, but not
hemiplegia)

- who demonstrate upper motor neuron signs (i.e. spasticity and/or hyperreflexia)

- who have been identified as high-risk for a motor disability by a physician

Exclusion Criteria:

- a history of uncontrolled seizures

- a diagnosis of a genetic disorder

- cardiac or orthopedic contraindications for standing and walking

- orthopedic surgery in the past 6 months

- use of spasticity-reducing medication or Botox injections in the past 6 months