Treadmill training and overground gait: decision making for a toddler with spina bifida

Pediatr Phys Ther. 2011 Spring;23(1):53-61. doi: 10.1097/PEP.0b013e318208a310.


Background and purpose: This case report describes a decision-making process that was used to progress a home-based intervention that coupled treadmill and walker stepping for a preambulatory toddler with spina bifida.

Case description: The toddler in this report had an L4-L5 level lesion, and began this home-based intervention at 18 months of age when she was pulling to stand.

Intervention: The intervention included parameters for treadmill stepping that prepared this toddler for gait with orthotics and was progressed to overground walking with a walker using a decision-making algorithm based on data obtained from a parent log and coded video.

Outcomes: This toddler progressed from not stepping at the start of the study to ambulating 150 m with a walker at age 23 months, after 18 weeks of this intervention.

Discussion and conclusion: The intervention and decision-making process used in this study were family centered and may be applicable to gait intervention with other populations.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Decision Support Techniques
  • Disability Evaluation
  • Exercise Test*
  • Gait Disorders, Neurologic / rehabilitation*
  • Gait*
  • Home Care Services
  • Humans
  • Infant
  • Male
  • Orthotic Devices
  • Physical Therapy Modalities
  • Range of Motion, Articular
  • Spinal Dysraphism / rehabilitation*
  • Treatment Outcome
  • Videotape Recording
  • Walking*