New report shows locomotor training restores walking function in child with spin

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New report shows locomotor training restores walking function in

child with spinal cord injury

Central nervous system may be retrained, report led by physical

therapist shows

http://www.eurekalert.org/pub_releases/2008-06/apta-nrs060408.php

A new report shows that a non-ambulatory (unable to walk or stand)

child with a cervical spinal cord injury was able to restore basic

walking function after intensive locomotor training. The case study,

published in Physical Therapy (May 2008), the scientific journal of

the American Physical Therapy Association (APTA), evaluated the

effects of locomotor training in a 4 ½ year-old-boy, who had no

ability to walk following a gunshot wound sixteen months earlier.

" Every standard clinical evaluation conducted on this child indicated

that he would not regain the ability to stand or walk, " said Dr

L Behrman, PT, PhD, Associate Professor in the Department of

Physical Therapy, University of Florida and APTA spokesperson.

Dr.Behrman, the lead author of the report, observes, " This case study

is significant in that it shows that a severely injured spinal cord

may be retrained. " But, Dr Behrman cautions that, while this is a

significant step in the right direction, not all children with severe

spinal cord injuries will benefit from this type of treatment or have

the same results.

Locomotor training refers to a process developed out of a partnership

with scientists in which the patient is put in an environment to

practice " walking " movements over and over again. Over the course of

76 sessions, the child was placed in an overhead body weight support

system and suspended over a treadmill while three trainers helped

simulate walking by moving his legs in a stepping pattern. " With this

system, the patient is partially supported, allowing the trainers to

faciliate stepping and standing movements, " Dr. Behrman explained.

She cautioned that many rehabilitation facilities lack the equipment

and staff skills to provide this kind of intense therapy, but that

her case study clearly shows what can happen when available. " We are

optimistic that this case study will give hope to individuals with

spinal cord injuries as well as to their families, " she said.

Dr Behrman noted that one month into locomotor training, voluntary

stepping began and the child eventually progressed from having no

ability to using his legs to moving with a rolling walker. The child

is now fully ambulatory with a walker and attends kindergarten using

a walker full-time. Although he has balance difficulties, requiring

the use of a walker, Dr. Behrman said that, in time, a walker may not

be necessary.

Dr Dena R Howland, OT, PhD, Associate Professor in the Department of

Neurological Science at the University of Florida's College of

Medicine, and a co-principal investigator for this case study, notes

that the complete support of the patient's family was a huge part of

his therapy success. " The fact that the physical therapists were able

to get the child to the level of functional ability that they did

most likely would not have been achieved without the perseverance and

commitment of this boy's family, " she said.

Dr Behrman added that research findings from reports such as this

serve to change and guide clinical practice for the physical therapy

profession. " Identifying patients who have the potential to benefit

from locomotor training or other therapies is an important step in

clinical decision making, " she said.

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Physical therapists are health care professionals who diagnose and

manage individuals of all ages, from newborns to elders, who have

medical problems or other health-related conditions that limit their

abilities to move and perform functional activities in their daily

lives. Physical therapists examine each individual and develop a plan

of care using treatment techniques to promote the ability to move,

reduce pain, restore function, and prevent disability. Physical

therapists also work with individuals to prevent the loss of mobility

by developing fitness- and wellness-oriented programs for healthier

and more active lifestyles.

The American Physical Therapy Association (www.apta.org) is a

national organization representing physical therapists, physical

therapist assistants, and students nationwide. Its goal is to foster

advancements in physical therapist education, practice, and research.

Consumers can visit www.findapt.us to find a physical therapist in

their area, as well as www.apta.org/consumer for physical therapy

news and information.