title: Locomotor training using body-weight support on a treadmill in conjunction with ongoing physical therapy in a child with severe cerebellar ataxia.
abstract: OBJECTIVE
  This case report describes the effects of locomotor training using body-weight support (BWS) on a treadmill and during overground walking on mobility in a child with severe cerebellar ataxia who was nonambulatory. To date, no studies have examined the efficacy of this intervention in people with cerebellar ataxia.
  
  
  METHODS
  The patient was a 13-year-old girl who had a cerebellar/brainstem infarct 16 months before the intervention. Her long-term goal was to walk independently in her home with a walker.
  
  
  METHODS
  Locomotor training using a BWS system both on the treadmill and during overground walking was implemented 5 days a week for 4 weeks in a clinic. Locomotor training using BWS on a treadmill was continued 5 days a week for 4 months at home.
  
  
  RESULTS
  Prior to training, she was able to take steps on her own with the help of another person, but did not take full weight on her feet or walk on a regular basis. At 6 months, she walked for household distances. Prior to training, her Pediatric Functional Independence Measure scores were 3 (moderate assistance) for all transfers, 2 (maximal assistance) for walking, and 1 (total assistance) for stairs. At 6 months, her scores were 6 (modified independence) for transfers, 5 (supervision) for walking, and 4 (minimal assistance) for stairs. Prior to training, she was unable to take independent steps during treadmill walking; at 6 months, all of her steps were unassisted.
  
  
  CONCLUSIONS
  Locomotor training using BWS on a treadmill in conjunction with overground gait training may be an effective way to improve ambulatory function in individuals with severe cerebellar ataxia, but the intensity and duration of training required for functionally significant improvements may be prolonged.
authors.affiliation: Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA 98195, USA. Cernak@u.washington.edu
authors.forename: Kristin
authors.initials: K
authors.lastname: Cernak
authors.forename: Vicki
authors.initials: V
authors.lastname: Stevens
authors.forename: Robert
authors.initials: R
authors.lastname: Price
authors.forename: Anne
authors.initials: A
authors.lastname: Shumway-Cook
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002524:Cerebellar Ataxia / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D016138:Walking / Q000502:physiology*