CONDITIONING EFFECTS OF BACKWARD TREADMILL TRAINING IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY

Abstract

Background: A new way to increase the challenge of walking is to walk backwards. Backward treadmill walking may provide advantages by promoting improvement in balance, walking spatiotemporal parameters and quality that may reflect in improving walking speed. Information about the energy expended by the patient during ambulation could provide objective data to help guide the decision-making process. Objective: To evaluate the effects of a backward treadmill training program in improving walking endurance in children with cerebral palsy. Materials and Methods: Twelve children diagnosed with spastic diplegic cerebral palsy from both gender were included in this study. They were divided into 2 groups, group A (control) received the regular therapeutic exercise program according to neurodevelopmental approach for such cases and group B (study) received the regular therapeutic exercise program for such cases along with 20 min backward treadmill walking using Biodex gait trainer equipment. Heart rate was monitored continuously each session for both groups. walking speed was assessed using The Biodex Gait Trainer 2TM and energy expenditure index was assessed by measuring heart rate using pulsometer (Japan model Tunturi TPN-400) for both groups before and after three months of the treatment program. Results: There was statistically significant improvement in walking speed in the study group (P<0.05) with significant difference when comparing post treatment results between groups (p<0.05), but The change in mean EEI scores was not significant when comparing post treatment results between groups while there were a significant improvement in mean EEI scores within groups. Conclusion: This study demonstrated an effective protocol using backward treadmill training to increase walking speed and endurance in children with CP. Although no significant change in EEI scores was noted and the sample size was small. This gait training method provides a safe and controlled environment for children to perform continuous walking at a cardiovascular training intensity to improve their gait and fitness.