Short-Term Therapeutic Effects of Anti-Gravity Treadmill Training on Brain Functional Activities and Walking Capacity in Children With Cerebral Palsy

Abstract

Introduction: Cerebral Palsy (CP) is one of the most common causes of motor disability in childhood. Since CP is a corollary to brain damage, persistent treatment should accompany an alteration in brain functional activity in line with clinical improvements. Methods: Fourteen children with spastic hemiplegia CP were randomly divided into 2 groups. The study group (8yrs-5mos) underwent 45min AlterG training sessions 3 times/week for 8 weeks, while the control group (8yrs-2mos) received the same amount of occupational therapy (OT). Functional magnetic resonance imaging (fMRI) was conducted to quantify brain activation during the performance of passive tasks including ankle plantarflexion to dorsiflexion and knee flexion to extension over the range of motion. Walking capacity was assessed using the Timed-Up-and-Go, 10-meter, and 6-minute walk tests. All evaluations were performed before and after training and compared between the two groups. Results: We were able to detect the signatures of ankle and knee passive movement tasks in the fMRI and characterize them in terms of activated voxels. The pre-post activation changes following the completion of training course showed that the elicited motor cortex activation was greater for the ankle than the knee tasks. For the ankle, primary motor cortex, precentral gyrus and corpus callosum showed significant enhancement in most study participants. The results indicated 16.1% more active voxels in the study than control groups. Similarly, clinical outcome measures improved over twice as much in this group. Conclusions: AlterG training could be a potentially effective therapeutic intervention for improving gait and balance impairments in children with CP.