Effectiveness of Treadmill Training versus Overground Walking for Children with Cerebral Palsy

Purpose: The aim of this literature review and case report was to answer the following PICO question via evidenced-based analysis: "In children younger than 12 years old, with cerebral palsy, does full weight bearing treadmill training, compared to overground walking, result in greater gains in walking independence and endurance?" Background: Treadmill training for children with cerebral palsy has been a popular topic in many pediatric physical therapy journals. However, many of these articles use partial body weight support (PBWS) devices, which are expensive and not very common in the clinical setting. Treadmills themselves are relatively common and are able to provide a lot of walking repetition as well as provide objective data on walking speed and distance. In addition, treadmills provide a safe walking environment, with no uneven surfaces or obstacles Case Description: : Carlos was a 4 year old male with a diagnosis of Cerebral Palsy (CP), currently receiving physical therapy services 1 hour a week, at a specialized school for the blind and visually impaired. He had very low tone, visual deficits, and had poor motor planning, making it difficult for him to meet his developmental milestones. Carlos was able to participant in 8 treadmill training sessions ranging from 5 to 15 minutes. Outcomes: The research comparing treadmill training to overground walking suggests treadmill training was significantly better at improving walking speed and gross motor development. Carlos was able to make substantial gains in his treadmill walking endurance and ability to increase his independent walking after treatment. Discussion: Treadmill training has been shown to improve various aspects of gait, however, treadmill protocols are still extremely variable. More research needs to be done to standardized treadmill training protocols to best fit this population