Adam T C Booth1,2, Annemieke I Buizer1, Pieter Meyns1,3, Irene L B Oude Lansink4, Frans Steenbrink2, Marjolein M van der Krogt1. 1. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands. 2. Department of Clinical Applications and Research, Motek Medical BV, Amsterdam, the Netherlands. 3. Faculty of Medicine and Life Sciences, REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium. 4. Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Abstract
AIM: The aim of this systematic review was to investigate the effects of functional gait training on walking ability in children and young adults with cerebral palsy (CP). METHOD: The review was conducted using standardized methodology, searching four electronic databases (PubMed, Embase, CINAHL, Web of Science) for relevant literature published between January 1980 and January 2017. Included studies involved training with a focus on actively practising the task of walking as an intervention while reporting outcome measures relating to walking ability. RESULTS: Forty-one studies were identified, with 11 randomized controlled trials included. There is strong evidence that functional gait training results in clinically important benefits for children and young adults with CP, with a therapeutic goal of improved walking speed. Functional gait training was found to have a moderate positive effect on walking speed over standard physical therapy (effect size 0.79, p=0.04). Further, there is weaker yet relatively consistent evidence that functional gait training can also benefit walking endurance and gait-related gross motor function. INTERPRETATION: There is promising evidence that functional gait training is a safe, feasible, and effective intervention to target improved walking ability in children and young adults with CP. The addition of virtual reality and biofeedback can increase patient engagement and magnify effects. WHAT THIS PAPER ADDS: Functional gait training is a safe, feasible, and effective intervention to improve walking ability. Functional gait training shows larger positive effects on walking speed than standard physical therapy. Walking endurance and gait-related gross motor function can also benefit from functional gait training. Addition of virtual reality and biofeedback shows promise to increase engagement and improve outcomes.
AIM: The aim of this systematic review was to investigate the effects of functional gait training on walking ability in children and young adults with cerebral palsy (CP). METHOD: The review was conducted using standardized methodology, searching four electronic databases (PubMed, Embase, CINAHL, Web of Science) for relevant literature published between January 1980 and January 2017. Included studies involved training with a focus on actively practising the task of walking as an intervention while reporting outcome measures relating to walking ability. RESULTS: Forty-one studies were identified, with 11 randomized controlled trials included. There is strong evidence that functional gait training results in clinically important benefits for children and young adults with CP, with a therapeutic goal of improved walking speed. Functional gait training was found to have a moderate positive effect on walking speed over standard physical therapy (effect size 0.79, p=0.04). Further, there is weaker yet relatively consistent evidence that functional gait training can also benefit walking endurance and gait-related gross motor function. INTERPRETATION: There is promising evidence that functional gait training is a safe, feasible, and effective intervention to target improved walking ability in children and young adults with CP. The addition of virtual reality and biofeedback can increase patient engagement and magnify effects. WHAT THIS PAPER ADDS: Functional gait training is a safe, feasible, and effective intervention to improve walking ability. Functional gait training shows larger positive effects on walking speed than standard physical therapy. Walking endurance and gait-related gross motor function can also benefit from functional gait training. Addition of virtual reality and biofeedback shows promise to increase engagement and improve outcomes.
Authors: Esther E H van Bommel; Marieke M E Arts; Peter H Jongerius; Julia Ratter; Eugene A A Rameckers Journal: Ther Adv Chronic Dis Date: 2019-07-05 Impact factor: 5.091
Authors: Adam T C Booth; Marjolein M van der Krogt; Jaap Harlaar; Nadia Dominici; Annemieke I Buizer Journal: Front Physiol Date: 2019-09-27 Impact factor: 4.566