Background/Purpose: Cerebral palsy is a group of neurological disorders that affect movement and motor control. Increased tone and spasticity due to central nervous system damage to the cerebellum and corticospinal tracts contribute to gross motor delay and limit mobility in many cases for children with a medical diagnosis of spastic diplegic cerebral palsy. Physical therapy intervention is often part of the medical management for these children with CP due to the delay and impairment in gross motor acquisition and functional mobility. Case Description: A two year old male patient was born prematurely and received a subsequent medical diagnosis of spastic diplegic cerebral palsy. He had increased tone and spasticity in his bilateral lower extremities and minimal involvement of his right upper extremity. Increased tone in his hip adductors and gastrocnemius muscles were contributing to the gross motor delay apparent upon evaluation. The personal goals voiced by the parents of this patient were to work toward independent or modified independent gait. Outcomes: This patient was seen for the first 8 weeks during a plan of care estimated to continue for a duration of 6 months after initial evaluation. During these 8 weeks, this patient was observed to increase his ability to dissociate his lower extremities in crawling, stair ascension, and overground ambulation with manual assistance. Gait training was provided for this patient via various types of gait trainers during the duration of his physical therapy sessions. Discussion: A literary review of current research suggests that overground gait training is superior to treadmill gait training in terms of gait kinematics and velocity. There is some evidence to support the use of a gait trainer for improved overall gait quality. Recent literature indicates partial body weight supported gait training appears to be less supported in children with cerebral palsy. Available research is limited by lack of high quality randomized controlled trails.
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Cerebral Palsy, Physical Therapy, pediatric, overground gait trainer, body weight supported gait
Torres, Nia. "Effect of Gait Training With Overground Gait Trainer Support Versus Partial Body Weight Supported Treadmill Training in Children with Spastic Diplegic Cerebral Palsy." (2015). http://digitalrepository.unm.edu/dpt/111