Treadmill training with partial body-weight support in children with cerebral palsy: a systematic review

The aim of this systematic review was to examine the literature on the effects of partial body-weight support treadmill training (PBWSTT) in children with cerebral palsy (CP) on functional outcomes and attainment of ambulation. We searched the relevant literature from 1950 to July 2007. We found eight studies on the use of PWSBTT on functional outcomes in children with CP. The methodology to develop systematic reviews of treatment interventions as suggested by the American Academy of Cerebral Palsy and Developmental Medicine and the Critical Review Form-Quantitative Studies Methodological Quality was used to evaluate each article. As two of the eight published articles reported on different outcomes of the same study, this review reports on seven studies with a total of 41 children. The evidence for the functional effects is limited. Statistical significance is not demonstrated in several of the studies, despite reported improvements in gross motor function, functional status, walking performance, and gait parameters. This systematic review is limited by the small number of participants, the heterogeneous level of abilities of participants from Gross Motor Function Classification System levels I to IV, and the low quality of trials. Because of these limitations, we cannot conclude that PBWSTT results in improvements for children with CP. Additional studies and well-established randomized controlled (or clinical) trials are clearly needed before determining the benefits and efficacy that would support continued use of this intervention in the clinical setting.