Lower-Body Positive Pressure Treadmill Training for Pediatric Gait Disorders: A Scoping Review

Yosra Cherni,Léandre Gagné-Pelletier,Catherine Mercier,Laurent Bouyer

doi:10.3390/app12010323

Yosra Cherni, Léandre Gagné-Pelletier + Show 2 more

Open Access

https://doi.org/10.3390/app12010323

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Abstract

The purpose of this scoping review was to examine the literature on the use of anti-gravity treadmills and its effects on lower-limb motor functions in children and adolescents with locomotor impairments. Method: Four databases (MEDLINE, CINAHL, Embase, Web of Science) were searched for articles from inception to August 2021. Inclusion criteria were: (1) experimental or quasi-experimental studies using anti-gravity training as the primary intervention; (2) studies conducted in pediatric participants; (3) articles reporting outcomes related to lower-limb functions; and (4) studies published in French or English. Results: Fifteen articles were included in the review. Studies included children and adolescents aged 4–18 years with locomotor impairments. Intervention duration ranged from 2 to 12 weeks, with 2–5 sessions per week. Included studies reported that anti-gravity training induces improvements in muscle strength, balance, spatiotemporal gait parameters, and walking endurance in children with locomotor impairments. Conclusion: This review provides relevant information about interventions, outcomes and limits associated with anti-gravity training in pediatrics. Overall, anti-gravity treadmill training could be viewed as a valuable training modality, specifically for children with cerebral palsy. However, a more precise and comprehensive description of anti-gravity training protocols would be useful.

Highlights

Locomotor impairments in children can result from different causes, including cerebral palsy, traumatic brain injury, orthopedic surgery or musculoskeletal pathology
Despite their usefulness for gait rehabilitation, it is important to underline the discomfort caused by lifting forces provided by the harnesses straps, which can impact the duration of training sessions and hinder a participant’s compliance with the training protocol
Min per session, 3 times per week for 8 weeks. This scoping review summarized the available literature on the effects of anti-gravity treadmill training on lower-limb function and/or gait parameters in children with locomotor impairments

Summary

Introduction

Locomotor impairments in children can result from different causes, including cerebral palsy, traumatic brain injury, orthopedic surgery or musculoskeletal pathology. BWS systems can potentially reduce ground reaction forces (i.e., average and/or peak vertical ground reaction forces), thereby allowing the intensity of training needed for rehabilitation while protecting the lower-limb joints [8,9] Despite their usefulness for gait rehabilitation, it is important to underline the discomfort caused by lifting forces provided by the harnesses straps, which can impact the duration of training sessions and hinder a participant’s compliance with the training protocol. To address this issue, some innovative BWS treadmill training systems employing lower-body positive-pressure support have been developed, of which the most widely distributed is the anti-gravity treadmill (AlterG® ) [10]. The aim of the present study was to perform a scoping review of the literature related to the use of anti-gravity treadmills and to identify profiles of pediatric populations with specific lower-limb motor-function deficits for which effects have been reported

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