Improvement in Overground Walking After Treadmill-Based Gait Training in a Child With Agenesis of the Corpus Callosum

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Abstract
Background: Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC. Objective: The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC. Design: A single-participant design with 2 phases was used. Methods: The settings were the participant’s home and the laboratory. The participant was a 13-year-old girl who had ACC and cortical visual impairment and who ambulated independently using a reverse walker for household and short community distances. A home-based TT intervention (2 phases of 3 months of training over 6 months) was implemented, and a laboratory-based gait analysis was conducted at 4 time points: baseline, after each of the 2 training phases, and 3 months after the cessation of training. The intervention consisted of weekly bouts of TT. Phase I incorporated forward, backward, and incline walking for 15 minutes each; in phase II, this protocol was continued, but short-burst interval training for 10 minutes was added. Data collected at each laboratory visit included spatiotemporal parameters and kinematics (joint angles) during overground and treadmill walking. Results: After both phases of training, increased step length, decreased step width, and foot progression angle and decreased variability of most spatiotemporal parameters were observed for the participant. Further, after phase II, increased peak extension at the hip, knee, and ankle, decreased crouched gait, and improved minimum foot clearance during overground walking were observed. Most gait improvements were retained for 3 months after the cessation of the intervention. Limitations: The small sample size of this study and wide variety of presentations within individuals with ACC limit the generalizability of our findings. Conclusions: TT may be a safe and effective treatment paradigm for children with ACC. Future research should investigate the effect of intervention dosage on gait improvements and generalization in individuals with ACC.

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