Efficacy of gait trainer as an adjunct to traditional physical therapy on walking performance in hemiparetic cerebral palsied children: a randomized controlled trial

Abstract

OBJECTIVE: To assess the effects of additional gait trainer assisted walking exercises on walking performance in children with hemiparetic cerebral palsy. DESIGN: A randomized controlled study. SETTING: Paediatric physical therapy outpatient clinic. SUBJECTS: Thirty spastic hemiparetic cerebral palsied children of both sexes (10-13 years - 19 girls and 11 boys). METHODS: Children were randomly assigned into two equal groups; experimental and control groups. Participants in both groups received a traditional physical therapy exercise programme. Those in the experimental group received additional gait trainer based walking exercises which aimed to improve walking performance. Treatment was provided three times per week for three successive months. MAIN MEASURES: Children received baseline and post-treatment assessments using Biodex Gait Trainer 2 assessment device to evaluate gait parameters including: average step length, walking speed, time on each foot (% of gait cycle) and ambulation index. RESULTS: Children in the experimental group showed a significant improvement as compared with those in the control group. The ambulation index was 75.53±7.36 (11.93 ± 2.89 change score) for the experimental group and 66.06 ± 5.48 (2.13 ± 4.43 change score) for the control group (t = 3.99 and P = 0.0001). Time of support for the affected side was 42.4 ± 3.37 (7 ± 2.20 change score) for the experimental group and 38.06 ± 4.63 (3.33 ± 6.25 change score) for the control group (t = 2.92 and P = 0.007). Also, there was a significant improvement in step length and walking speed in both groups. CONCLUSION: Gait trainer combined with traditional physiotherapy increase the chance of improving gait performance in children with spastic hemiparetic cerebral palsy.