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

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.