Power Training Combined With Interval Treadmill Training
Power Training Combined With Interval Treadmill Training
Ambulatory children with cerebral palsy (CP) experience walking limitations which negatively
 influence their ability to physically participate in day to day life. The investigators
 propose that impaired muscle power generation is the key limiting factor affecting walking
 activity and participation. This proposal represents a combined approach where participants
 undergo resistance training for muscle power generation in combination with locomotor
 treadmill training that is based on typical pediatric walking and activity patterns rather
 than adult protocols, which are endurance or time-based. Therefore, the primary objective of
 this randomized controlled trial is to determine the effect of lower extremity Power Training
 combined with interval Treadmill Training (PT³) on functional walking capacity and
 community-based activity and participation in children with CP. We hypothesize that
 remediating the most pronounced muscle performance impairment (i.e., muscle power) with power
 training combined with a task- specific approach to walking that is developmentally
 appropriate will have a significant effect on walking capacity and performance.
The primary purpose of this randomized controlled trial is to test the effect of Power
 Training combined with interval Treadmill Training (PT³) on walking capacity and performance
 in children with CP with walking limitations. To identify key muscular mechanisms associated
 with improved walking mobility, the effects of PT³ on muscle performance and architecture
 will be examined. The premise of the PT³ protocol is that a combined impairment and
 task-specific approach that is developmentally appropriate and targets muscle power deficits
 specifically, is necessary to drive changes in both clinic and community-based walking
 activity.

 In this randomized multi-site clinical trial, 48 ambulatory participants with CP will receive
 either PT³ or an equivalent dosage of traditional strength training combined with traditional
 treadmill training (comparison group) for 24 sessions, 3 times per week for 8 weeks. Outcomes
 will be collected at baseline and immediately post-treatment. Short and long-term retention
 effects will be assessed at 2 and 6 months post.
Inclusion Criteria:

 -  Diagnosis of bilateral spastic Cerebral Palsy (CP)

 -  Age 10 to 17 years inclusive

 -  GMFCS levels I, II, or III

 Exclusion Criteria:

 -  Orthopedic or neurosurgery less than 12 months prior to enrollment

 -  Injection therapies (phenol, botulinum toxin) less than 3 months prior to enrollment

 -  Lacking greater than 25 degrees of knee extension