Locomotor Training with Partial Body Weight Support on a Treadmill in a Nonambulatory Child with Spastic Tetraplegic Cerebral Palsy: A Case Report

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Abstract
Recent findings by neuroscientists serve as the basis for a new approach to training stepping after neurologic injury. The purpose of this case report was to describe the outcomes for one child with cerebral palsy after locomotor training. The child was a nine-year-old boy diagnosed with spastic tetraplegic cerebral palsy. He could not support his weight upright against gravity and had never experienced walking. Forty-four sessions of locomotor training with partial body weight support (BWS) included static step practice, weight shifting, and walk training on a treadmill. The Gross Motor Function Measure (GMFM) and the Pediatric Evaluation of Disability Inventory (PEDI) were administered prior to and immediately after training. The child demonstrated improvements in all domains of the GMFM and both domains of the PEDI. He was able to complete up to 60 independent steps on the treadmill while supported in the BWS harness. Four months after training, he was able to walk over ground short distances with a rolling walker and minimal assistance. This case report is the first to report improvement in stepping on a treadmill with carryover to over-ground walking in a nonambulatory child of this age with spastic tetraplegic cerebral palsy.