New Cerebral Palsy Treatment/Therapy - Walking Under Water

11-14-2006

BACKGROUND: Cerebral palsy is an umbrella-like term used to describe a group of chronic disorders that affect a person's movement early in his or her life. These disorders are caused by damage to motor areas in the brain that control movement and posture. Early signs of cerebral palsy usually appear before 3 years of age. Cerebral palsy may be congenital or acquired after birth. There is no standard therapy that works for all patients. Drugs can be used to control seizures and muscle spasms; special braces can compensate for muscle imbalance. Surgery and mechanical aids are other treatments, and although there is no cure for CP, medical advancements have allowed patients to lead near-normal lives.

UNDERWATER TREADMILL: Don Morgan, Ph.D., an exercise physiologist at Middle Tennessee State University in Murfreesboro, has begun a study testing an underwater treadmill on kids with CP as part of physical therapy. Underwater treadmills were first used on horses and have since been used for rehabilitating athletes, but this is the first time they've been tested on those with movement disorders. Kids with CP fatigue easily when the walk or run, and Dr. Morgan is aiming to see whether walking on the treadmill will improve walking ability and endurance.

BENEFITS: Advantages of walking on a treadmill underwater -- instead of on land -- are that there is resistance from the water that improves leg strength, but the water is also supportive, so there's less joint stress. Warm water is also comfortable on the muscles. Dr. Morgan says this "combines strength and locomotion and does so in an endurance context." He says parents have reported changes in their kids like having more balance while walking, not falling as much, and having more energy to walk.

THE STUDY: As part of his trial, CP patients undergo three weeks of pre-testing, 10 weeks of testing on the treadmill, and then a few weeks of post-testing. In the beginning, kids start off walking in waist-level water, and the water level is gradually lowered over the course of the study, as well as increases in walking speed and duration. There is also a screen for kids to watch videos or DVDs while they walk.

FUTURE: Dr. Morgan says his study focuses on kids with CP who are independently mobile -- that is, they don't need walkers or wheelchairs. The underwater treadmill could potentially be studied in kids who aren't independently mobile and could see even greater benefits. The treadmill could also be tested in other kids and adults with other diseases that affect mobility -- like multiple sclerosis, muscular dystrophy and juvenile arthritis.

STORIES: Swimming, splashing, sliding ... most kids love the water, and 11-year-old Sarah Grace is no different.

But all the water works is actually physical therapy. Sarah Grace was born more than four months premature and weighed just over one pound. She was the smallest baby to ever survive at her hospital.

"She literally was a miracle. Half inch shorter than a Barbie doll," said Sara' Grace's mom, Teresa Harris...

...And Sara Grace has been beating the odds ever since. She was diagnosed with cerebral palsy at age 2 and is now part of a study on how an underwater treadmill -- first used on horses -- can help her build up leg strength and walk better.

"It's a challenge. It'd be a challenge for anybody," Don Morgan, Ph.D., an exercise physiologist at Middle Tennessee State University in Murfreesboro, explained. "They're demonstrating to themselves and to their families that, 'Hey, look at what I've been able to do. I've gotten stronger. I've gotten fitter,' and it's a wonderful thing to be proud of."

Dr. Morgan says the water resistance helps build leg muscles but doesn't strain the joints. Kids in the study have improved heart function and have more energy to walk. Dr. Morgan says next it could be tested in kids with CP who use walkers and wheelchairs and in other conditions that affect walking.

After using the underwater treadmill, Sarah Grace noticed a difference during a class trip to New York City.

Teresa said, "When we went down a flight of steps to use the restroom, and when we came back up she was taking them just like me. I couldn't believe it. 'Baby, look what you're doing!'"

Sarah Grace dreams of someday becoming a nurse or teacher. "I'm more of like an energetic person," she said. "I will help people when they need help." And for a girl who couldn't even walk -- and can now climb stairs -- anything's possible.

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