Efficacy of Concurrent Cognitive-Motor Training on Gait in Hemiparetic Cerebral Palsy: A Randomized Controlled Trial

Abstract

Background: Interference between cognitive tasks and motor control activities such as walking is crucial for functional enhancement in patients with neurological disorders. Therefore, both cognitive and motor training should be addressed in planning physical therapy programs. Objective:To assess the efficacy of concurrent cognitive-motor training on gait in children with hemiparetic cerebral palsy. Materials and Methods:Thirty children with hemiparetic cerebral palsy of both sexes (10-14 years) shared in this study. They were randomly assigned into two equal groups; experimental and control groups. Children in the experimental group received a traditional physical therapy exercise program in addition to a gait training program given concurrently with cognitive tasks. Those in the control group received the same traditional physical therapy and gait training programs without any concurrent cognitive tasks. Treatment was provided three times per week for three successive months. The participants received baseline and post-treatment assessments for dimension E of Gross Motor Function Measure (GMFM) and some gait parameters including: step length, walking speed, ambulation index and time of support on the affected side (% of gait cycle).Results: Children in both groups showed significant improvement post treatment in GMFM scores and all measured gait parameters (p<0.05) with a higher improvement in the experimental group. After the intervention, between-group comparison revealed significant differences for ambulation index (t=3.16, p=0.004) and time of support on the affected side (t=3.61, p=0.001) in favour of the experimental group. No significant between-group differences were found in GMFS scores, step length and walking speed (p > 0.05). Conclusion:Concurrent cognitive-motor training increased the chance of improving walking ability in children with hemiparetic cerebral palsy as compared to the motor training alone.