Physical Therapists have long sought strategies to improve functional ambulation in children with cerebral palsy and other neuromotor disorders. While a variety of treatments have evolved from NDT, dynamic systems approach, and intensive stretching, strengthening, and postural control programs, no clinical treatment methodology has been published that establishes positive measurable outcomes in the development of gait. More recent tools have emerged to expand treatment options including partial body weight treadmill training, (PBWTT), supportive garments, and assistive devices for gait. However, the challenge remains for the physical therapist to incorporate all of these techniques into an effective strategy for increasing independence in ambulation in children with cerebral palsy.
This course will review typical walking development in children, the components of bipedal locomotion in mature walking, and the necessary systems to support independent locomotion. A discussion of gait development in children with neuromotor disorders will focus on barriers in pre-ambulation skills, opportunities for impairment-based and activity-focused interventions, and optimal timing for establishing key components of gait. Using an assessment-interventions-outcomes treatment paradigm, therapeutic exercises and activities will be discussed to stimulate postural control, strength, and gait parameters in children with CP.
Additionally, the course instructor will discuss her pilot study, which measured the effects of a 4-week intensive physical therapy program on locomotor skills in children with spastic cerebral palsy. The study included progression of PBWTT and the use of GMFM, PEDI, pedographs, and timed walks to measure outcomes. Finally, through the use of videotape reviews and treatment demonstration, the instructor will review clinical decision-making skills to promote walking.