Effect of Treadmill Gait Training Combined With Conventional Physiotherapy on Gait Performance and Functional Mobility in Children With Bilateral Spastic Cerebral Palsy: A Randomized Controlled Trial (GAIT-CP)
調査の概要
状態
詳細な説明
Bilateral spastic cerebral palsy (CP) is associated with lower-limb spasticity, impaired motor control, abnormal gait patterns, reduced walking speed, and limitations in functional mobility. Task-specific repetitive locomotor training is an important component of pediatric neurorehabilitation, and treadmill gait training may enhance stepping practice and improve gait-related outcomes.
This assessor-blinded, parallel-group randomized controlled trial aims to evaluate the effect of treadmill gait training combined with conventional physiotherapy compared with conventional physiotherapy alone in children with bilateral spastic CP. Children aged 6-16 years with GMFCS Level I-III will be recruited from Syeda Khatoon e Jannat Trust Hospital.
Participants will be randomly allocated into two groups. The intervention group will receive treadmill gait training (30 minutes/session, 3 sessions/week for 12 weeks) in addition to conventional physiotherapy, including stretching, strengthening, balance training, and functional activities. The control group will receive conventional physiotherapy alone.
Outcomes will be assessed at baseline and after intervention using the Gross Motor Function Measure (GMFM-66) as the primary outcome, along with the 10 Meter Walk Test, Timed Up and Go Test, Pediatric Balance Scale, Modified Ashworth Scale, and 6 Minute Walk Test to evaluate gait performance, functional mobility, balance, spasticity, and walking endurance.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Punjab Province
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Faisalabad、Punjab Province、パキスタン、3800
- Syeda Khatoon e Jannat Trust Hospital & Special Education Centre
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参加基準
適格基準
就学可能な年齢
- 子
健康ボランティアの受け入れ
説明
Inclusion Criteria
- Clinically confirmed diagnosis of bilateral spastic cerebral palsy.
- Aged 6 to 16 years.
- Classified as GMFCS Levels I-III.
- Able to stand independently, with or without support.
- Presence of clinically significant lower-limb spasticity, defined as Modified Ashworth Scale (MAS) score ≥2.
- Demonstrated ambulatory ability with Timed Up and Go (TUG) ≤10 seconds.
- Demonstrated walking ability with 6-Minute Walk Test (6MWT) distance of 50-500 meters at baseline.
- Able to understand simple verbal commands and participate in structured therapy sessions.
- Parent or legal guardian willing to provide written informed consent.
- Willing and able to attend the complete 12-week intervention protocol. Exclusion Criteria
- Botulinum toxin injection within the previous 6 months.
- Recent pharmacological intervention significantly affecting spasticity.
- Lower-limb orthopedic surgery within the previous 12 months.
- Severe intellectual disability (IQ <70) or inability to follow simple instructions required for therapy participation.
- Uncontrolled seizures, epilepsy, or other neurological conditions that could interfere with participation.
- Fixed musculoskeletal contractures limiting standing, stepping, or gait training.
- Cardiopulmonary, medical, or orthopedic conditions that contraindicate treadmill-based exercise.
- Current participation in another gait-training or rehabilitation research study.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Treadmill Gait Training + Conventional Physiotherapy
Participants will receive treadmill gait training combined with conventional physiotherapy for 12 weeks. Treadmill training will be provided for 30 minutes per session, 3 sessions per week (total 36 sessions). Treadmill speed, assistance level, and progression will be individually adjusted according to participant tolerance, gait quality, and safety. Sessions will be supervised by a qualified physiotherapist. The conventional physiotherapy program will include stretching exercises, strengthening exercises, balance training, and functional task-oriented activities including sit-to-stand practice, stair training, and obstacle negotiation. |
A task-specific locomotor training intervention involving treadmill walking practice for 30 minutes per session, 3 sessions per week for 12 weeks, combined with conventional physiotherapy.
A rehabilitation program including stretching, strengthening, balance training, and functional activities aimed at improving mobility and motor function in children with bilateral spastic cerebral palsy.
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アクティブコンパレータ：Conventional Physiotherapy
Participants will receive conventional physiotherapy for 12 weeks, 3 sessions per week.
The rehabilitation program will include stretching exercises, strengthening exercises, balance training, and functional task-oriented activities.
The intervention will follow the same duration and frequency as the experimental group but without treadmill gait training.
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A rehabilitation program including stretching, strengthening, balance training, and functional activities aimed at improving mobility and motor function in children with bilateral spastic cerebral palsy.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in Gross Motor Function Measure-66 (GMFM-66) Score
時間枠：Baseline and Week 12
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The Gross Motor Function Measure-66 (GMFM-66) is a standardized and validated observational assessment used to evaluate changes in gross motor function in children with cerebral palsy.
This study will assess changes in the Standing (Dimension D) and Walking, Running, and Jumping (Dimension E) domains to evaluate improvements in functional mobility and gait-related abilities.
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Baseline and Week 12
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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MAS
時間枠：Baseline and Week 12
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randomised controlled trial
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Baseline and Week 12
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Change in 10 Meter Walk Test (10MWT) Walking Velocity
時間枠：Baseline and Week 12
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The 10 Meter Walk Test measures walking speed over a 10-meter distance.
Walking velocity (meters/second) will be assessed to determine changes in gait speed and locomotor efficiency following intervention.
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Baseline and Week 12
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Change in Timed Up and Go Test (TUG) Performance
時間枠：Baseline and Week 12
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The Timed Up and Go Test measures functional mobility and dynamic balance by recording the time required to stand from a chair, walk 3 meters, turn, return, and sit down.
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Baseline and Week 12
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Change in Pediatric Balance Scale (PBS) Score
時間枠：Baseline and Week 12
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The Pediatric Balance Scale is a 14-item performance-based measure used to assess functional balance abilities in children.
Changes in balance performance will be evaluated following the intervention.
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Baseline and Week 12
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Change in Modified Ashworth Scale (MAS) Score
時間枠：Baseline and Week 12
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The Modified Ashworth Scale is an ordinal clinical scale used to assess changes in muscle spasticity.
Lower-limb muscle groups including hip adductors, hamstrings, and gastrocnemius-soleus muscles will be evaluated.
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Baseline and Week 12
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Change in 6 Minute Walk Test (6MWT) Distance
時間枠：Baseline and Week 12
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The 6 Minute Walk Test measures walking endurance by recording the total distance walked in 6 minutes.
It will be used to evaluate changes in functional walking capacity.
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Baseline and Week 12
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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MAS
時間枠：Baseline and Week 12
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randomised controlled trial
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Baseline and Week 12
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協力者と研究者
捜査官
- 主任研究者：Dr. Tehreem Jameel, DPT; PGD-PPT、Syeda Khatoon e Jannat Trust Hospital & Special Education Centre
出版物と役立つリンク
一般刊行物
- Alotaibi A, Ibrahim A, Ahmed R, Abualait T. Effectiveness of Partial Body Weight-Supported Treadmill Training on Various Outcomes in Different Contexts among Children and Adolescents with Cerebral Palsy: A Systematic Review and Meta-Analysis. Children (Basel). 2023 Dec 20;11(1):9. doi: 10.3390/children11010009.
- Chen Y, Li X, Wang L, et al. Effects of neuromuscular and physical therapy interventions on lower limb spasticity and gait performance in children with cerebral palsy: systematic review and meta-analysis. Front Pediatr. 2023;11:1185672.
- Desloovere K, Molenaers G, Feys H, et al. Evidence-based interventions for improving gait function in children with cerebral palsy: clinical perspectives and rehabilitation approaches. Dev Med Child Neurol. 2021;63(5):567-575.
- Liang X, Tan Z, Yun G, Cao J, Wang J, Liu Q, Chen T. Effectiveness of exercise interventions for children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials. J Rehabil Med. 2021 Apr 1;53(4):jrm00176. doi: 10.2340/16501977-2772.
- Han YG, Yun CK. Effectiveness of treadmill training on gait function in children with cerebral palsy: meta-analysis. J Exerc Rehabil. 2020 Feb 26;16(1):10-19. doi: 10.12965/jer.1938748.374. eCollection 2020 Feb.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- 003-SKJWF-2026
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