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Dippenaar A.1, Fell B.1, Fourie M.1, Hime S.1, Janse Van Rensburg E.1, Inglis-Jassiem G.1
1Stellenbosch University, Faculty of Medicine & Health Sciences, Physiotherapy, Cape Town, South Africa
Background: Cerebral Palsy (CP) is a common cause of physical disability in children and affects activities of daily living. Children with CP have problems with ambulation and balance. Partial bodyweight supported treadmill training (PBWSTT) is an intervention that provides task specific gait training.
Purpose: To determine if PBWSTT is more effective, in improving function and gait in ambulatory children and adolescents with CP compared to physiotherapy and/or overground gait training
Methods: Seven databases namely CINAHL, Cochrane, OT Seeker, PEDro, Pubmed, Science Direct, and Scopus were searched by five reviewers. Search terms included treadmill training, Cerebral Palsy, Physical Therapy OR Physiotherapy, partial body weight, function, gait OR walking. The adapted JBI Data Extraction Form was used to extract data from the selected articles and results are presented in narrative form and where applicable, statistical pooling was used.
Results: The four RCTs used for this SR scored an average of 7/11 on the PEDro scale. The results show an improvement for all outcomes in the PBWSTT group as well as the physiotherapy group, but there was no significant difference between the two groups barring one. The only outcome that showed a significant difference was gait speed, where treadmill training proved to be the more favourable treatment in the short-term (2-4 weeks). It indicates a statistically significant difference which favours PBWSTT group compared to the physiotherapy group (p = 0.04).
Conclusion(s): In conclusion there is high level evidence (II) that suggest that PBWSTT has no clinical significant advantage over physiotherapy and/or overground walking. Statistical significance was only found for short-term effects in gait speed with the use of PBWSTT for children with CP.
Implications: PBWSTT may be valid treatment option to improve gait speed and offers task specific training for children with CP, resources permitting. Factors to consider include financial resources, staff, equipment and special training. Its widespread implementation is not yet indicated as the effects on other gait parameters and function has not been established as statistically significant. Physiotherapy and/or overground gait training continues to be the intervention of choice as it demonstrates a positive impact on gait and function in children with CP.
Funding acknowledgements: Nil funding
Topic: Paediatrics
Ethics approval: Undergraduate physiotherapy student research project and due to its nature, secondary research (Systematic review), no ethical clearance was required.
All authors, affiliations and abstracts have been published as submitted.
