Children with disabilities may lose muscle tone, but one research project has some patients being able to stand and walk.

Tristan Schilling was diagnosed with Cerebral Palsy as a baby and doctors were not sure if he would survive. Now at ten years old, Schilling is determined as ever to lead a normal life.

"He has so much will and desire and spirit and the motivation to just do what he wants to do," said Vicki Schilling, mother.

Tristan and others like him participated in a study at Shriners Hospital in Philadelphia where they trained for four weeks on a special treadmill. Researchers designed the work out to help improve their fitness, coordination, and mobility.

"We just really wanted to give them a jumpstart and an opportunity to try walking in an environment that is safe for them, that they can trust a little bit more," said Josephic.

Some of Tristan's body weight is supported by the equipment so he can practice moving his muscles used for walking. The intense training that Tristan undergoes paid off.

"In general children were able to walk faster, be up more often and are more functional," said Josephic.

"The biggest thing that we've seen is that he has started to crawl, and also pull himself up onto his knees, and also make attempts to pull himself even up onto his feet," said Vicki.

The treadmill therapy alone will not get Tristan walking, but it does get him closer.

"Some kids out there just give up and don't wanna walk," said Tristan. "They stay in a wheelchair forever, but me, I'm not giving up."

The "step" program is part of an ongoing treadmill study and is being conducted at Shriners Hospitals for children.

You can find out more about their research by accessing the Shriner's main Web site at shrinershq.org.

Fast facts:
About 500,000 americans have cerebral palsy. Each year, about 8,000 infants and 1,500 preschoolers are diagnosed with the condition.
Some children with cerebral palsy have difficulty walking without some form of assistance; others need a wheelchair to get around.
Researchers at shriner’s hospital are using a special treadmill to increase musculoskeletal fitness in children with cerebral palsy and improve their ability to walk.
For more details, refer to our comprehensive research summary.

SUPPLEMENTAL INFORMATION
Cerebral Palsy
Cerebral palsy is a neurological condition that affects movement and muscle coordination. It is caused by damage to brain before, during or shortly after birth. Children may show signs of slow motor development, weak muscle tone, problems with fine motor tasks and difficulty walking or keeping balance.

According to the National Dissemination Center for Children with Disabilities, about 500,000 Americans have cerebral palsy. Roughly 8,000 infants and 1,500 preschoolers are diagnosed with the condition each year. Seventy percent of cases occur before birth (congenital cerebral palsy) and are caused by a disruption in the normal development of a part of the brain. Infection during pregnancy and poor oxygen supply to the fetus are possible causes of congenital cerebral palsy. In many cases, the cause is unknown. About 20 percent of children acquire cerebral palsy from birth complications, like asphyxia during labor and delivery. Ten percent of cases are acquired shortly after birth from some type of damage to the infant brain, like brain infection or head trauma.

There are three main types of cerebral palsy. Children who have signs of more than one type are said to have a mixed form of the condition. Spastic cerebral palsy is the most common form of the condition, affecting 70 to 80 percent of patients. The muscles are stiff, tight and contracted (causing the limb to permanently bend). One or both sides of the body may be affected. Athetoid, or dyskinetic cerebral palsy, occurs in 10 to 20 percent of patients. It affects the entire body and is characterized by changes in muscle tone and abnormally slow, writhing movements of the hands, arms, feet or legs. The movements may increase during periods of stress and decrease during sleep. If the muscles of the face are involved, patients may have problems with speech or drooling. Ataxic cerebral palsy is the rarest form of the condition, affecting 5 to 10 percent of patients. It generally affects balance and coordination, causing an unsteady gait, poor coordination, tremor and problems with fine motor skills.

Treadmill Training for Children with Cerebral Palsy
Researchers at Shriners Hospital for Children in Philadelphia, are using treadmill training for children with cerebral palsy. The program is called Speed Supported Treadmill Training Exercise Program (SSTTEP). There are two goals. One is to improve a child’s function by strengthening leg and trunk muscles and improving balance, ability to stand and gait. The second goal is to improve fitness. Since many children with cerebral palsy are in a wheelchair or have difficulty getting around, they walk very slowly (or not at all) and often lack endurance.

To prepare for the treadmill, the child is placed in a special suit, or harness. The harness provides safety and support and is attached to a device that slightly suspends the child in the air. During training, the therapist helps the patient learn to use the appropriate muscles for walking. The height of the treadmill system can be adjusted so the child puts very little weight on his/her feet while walking, reducing the amount of effort needed to “walk.” The speed of the treadmill can also be increased in very small increments to match the child’s function and fitness levels.

In a pilot study, children walked for 30 minutes at a time, three times a day for five days a week. After four weeks of the intensive therapy, researchers found participants had greater function and could walk faster and further. Studies with treadmill training are still ongoing.

Web Resources:
For information on cerebral palsy:
centers for disease control and prevention, http://www.cdc.gov
children’s hemiplegia and stroke association, http://www.chasa.org
march of dimes®, http://www.marchofdimes.com
national dissemination center for children with disabilities, http://www.nichcy.org
national institute of neurological disorders and stroke, http://www.ninds.nih.gov
united cerebral palsy™, http://www.ucp.org