Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis

Abstract

Gait training was the most effective intervention in improving gait speed for ambulatory children with CP. Strength training, even if properly dosed, was not shown to be effective in improving gait speed. Velocity training, electromyographic biofeedback training, and whole-body vibration were effective in improving gait speed in individual studies and warrant further investigation.

Task-Specific and Functional Effects of Speed-Focused Elliptical or Motor-Assisted Cycle Training in Children With Bilateral Cerebral Palsy: Randomized Clinical Trial

“…A recent systematic review of interventions for children with CP aimed to improve gait speed demonstrated that gait training was the most effective in increasing gait speed with resistance training not shown to be effective, with the exception of high velocity (power) training 38 . Given the task specificity of gait training, this finding is not entirely surprising.…”

Coupling Timing of Interventions With Dose to Optimize Plasticity and Participation in Pediatric Neurologic Populations

“…64 Studies with locomotion training that occurred at a frequency of at least twice a week, for 30 minutes, for greater than 9 weeks had the largest effect sizes. 64 Results of several studies report changes at the level of body structures and function, including improved endurance, 94–97 reduced ankle stiffness, 97 , increased H-reflex latency, 98 and improved gait kinematics. 99 One investigation used coherence of EMG analysis as a way of measuring and detecting changes in the output of the motor cortex and its transmission to the spinal cord through the corticospinal tract during functional muscle activation.…”

“…62, 63 Despite moderate increases in strength, there is no evidence to support that resistance training improves walking speed 64 or changes in gross motor function. 65 One study demonstrates resistance and velocity training both increase strength, but only velocity training produced positive changes in muscle architecture and gait speed.…”

“…64 The interventions have similar effectiveness, 93 although there is a trend for greater effect sizes in studies with over-ground training. 64 Studies with locomotion training that occurred at a frequency of at least twice a week, for 30 minutes, for greater than 9 weeks had the largest effect sizes.…”

“…64 The interventions have similar effectiveness, 93 although there is a trend for greater effect sizes in studies with over-ground training. 64 Studies with locomotion training that occurred at a frequency of at least twice a week, for 30 minutes, for greater than 9 weeks had the largest effect sizes. 64 Results of several studies report changes at the level of body structures and function, including improved endurance, 94–97 reduced ankle stiffness, 97 , increased H-reflex latency, 98 and improved gait kinematics.…”