title: Ankle dorsiflexion fMRI in children with cerebral palsy undergoing intensive body-weight-supported treadmill training: a pilot study.
abstract: This pilot study investigated the feasibility of using functional magnetic resonance imaging (fMRI) as a physiological marker of brain plasticity before and after an intensive body-weight-supported treadmill training (BWSTT) program in children with cerebral palsy (CP). Six ambulatory children (four males, two females; mean age 10y 6mo, age range 6-14y) with spastic CP (four hemiplegia, two asymmetric diplegia, all Gross Motor Function Classification System Level I) received BWSTT twice daily for 2 weeks. All children tolerated therapy; only one therapy session was aborted due to fatigue. With training, over ground mean walking speed increased from 1.47 to 1.66m/s (p=0.035). There was no change in distance walked for 6 minutes (pre-: 451m; post-: 458m;p 0.851). In three children, reliable fMRIs were taken of cortical activation pre- and post-intervention. Post-intervention increases in cortical activation during ankle dorsiflexion were observed in all three children. This study demonstrates that children with CP between 6 and 14 years of age can tolerate intensive locomotor training and, with appropriate modifications, can complete an fMRI series. This study supports further studies designed to investigate training-dependent plasticity in children with CP.
authors.affiliation: Department of Neurology and Pediatrics, University of New Mexico Health Science Center, Albuquerque, NM 87131-0001, USA. jpphillips@salud.unm.edu
authors.forename: John P
authors.initials: JP
authors.lastname: Phillips
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Sullivan
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Burtner
authors.forename: Arvind
authors.initials: A
authors.lastname: Caprihan
authors.forename: Beth
authors.initials: B
authors.lastname: Provost
authors.forename: Ann
authors.initials: A
authors.lastname: Bernitsky-Beddingfield
mesh_terms: D000293:Adolescent; D000842:Ankle / Q000503:physiopathology*; D001835:Body Weight; D001921:Brain / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D005684:Gait; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009473:Neuronal Plasticity / Q000502:physiology; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome