title: Randomized controlled study of home-based treadmill training for ambulatory children with spina bifida.
abstract: BACKGROUND
  Many ambulatory children with spina bifida (SB) decline in their walking despite stable or even improved motor function.
  
  
  OBJECTIVE
  The authors evaluated the effects of a home-based treadmill training program on both ambulatory function and aerobic fitness.
  
  
  METHODS
  This randomized clinical trial of 34 ambulatory children with SB allocated 18 to supervised treadmill training for 12 weeks at home and 14 to usual care. Patients in home training exercised twice a week at an intensity of 66% of HR(peak) (peak heart rate) and gradually progressed from 70% to 140% of their individual walking speed. Main outcome measures were obtained at baseline, after intervention, and 3 months postintervention. Ambulation was measured using the 6-minute walk test (6MWT), during which gross energy consumption (ECS(gross)) and energy cost were calculated. Maximal exercise capacity was measured using an incremental treadmill test. Both VO(2peak) and speed(peak) were recorded as outcome parameters.
  
  
  RESULTS
  After training, significant changes were seen between the groups for 6MWT (P = .002; d = 1.08), speed(peak) (P = .001; d = 1.14), VO(2peak) (P = .034; d = 0.78), and ECS(gross) (P = .004; d = 1.01). Long-term effects were recorded for 6MWT (P = .003; η = 0.34), speed(peak) (P = .003; η = 0.35), and ECS(gross) (P = .014; η = 0.29) but not for VO(2peak).
  
  
  CONCLUSIONS
  A home-based, progressive treadmill training program for ambulatory children with SB has a large long-term effect on ambulation, with a moderate short-term effect on VO(2peak).
authors.affiliation: University of Applied Sciences, Utrecht, the Netherlands. Janke.degroot@hu.nl
authors.forename: Janke F
authors.initials: JF
authors.lastname: de Groot
authors.forename: Tim
authors.initials: T
authors.lastname: Takken
authors.forename: Marco
authors.initials: M
authors.lastname: van Brussel
authors.forename: Rob
authors.initials: R
authors.lastname: Gooskens
authors.forename: Marja
authors.initials: M
authors.lastname: Schoenmakers
authors.forename: Chantal
authors.initials: C
authors.lastname: Versteeg
authors.forename: Luc
authors.initials: L
authors.lastname: Vanhees
authors.forename: Paul
authors.initials: P
authors.lastname: Helders
mesh_terms: D000293:Adolescent; D015308:Anaerobic Threshold / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D004734:Energy Metabolism / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D018763:Muscle Fatigue / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness; D011597:Psychomotor Performance / Q000502:physiology; D012885:Skinfold Thickness; D012959:Socioeconomic Factors; D016135:Spinal Dysraphism / Q000534:rehabilitation*; D016138:Walking / Q000502:physiology