Abstract
CASE HISTORY: 26-year-old Caucasian male. Primary medical history includes spastic quadriplegic cerebral palsy, otherwise negative health history. Presented to human performance laboratory for case study of pre- and post-exercise training cardiorespiratory fitness testing. PHYSICAL EXAM: Patient examination indicated bilateral upper and lower limb contractures, and bilateral upper and lower limb spasticity. Hyperlordosis was also noted. Patient had a limited range of motion across hip, knee, and ankle, and was unable to walk without support on a motorized treadmill. DIFFERENTIAL DIAGNOSES: General: Alert and oriented. Neural: spastic upper and lower extremities. Musculoskeletal: upper and lower extremity contractures. TESTS & RESULTS: A modified graded treadmill test was performed. Patient’s body mass was supported by a harness system, ankle-foot orthoses were used for ankle stabilization, and SWASH was worn to prevent excessive hip adduction to enable treadmill testing. Heart rate (HR), respiratory rate (RR), and respiratory exchange ratio (RER), were measured as patient walked at 26.8 m/s and grade. Patient reached stage 9 with a max HR (196 bpm), RR (50 breaths/minute), and RER of .99. FINAL DIAGNOSIS: General: Alert and oriented, non-ambulatory, wheel-chair bound. Neural: spastic upper and lower extremities. Musculoskeletal: upper and lower extremity contractures. Low cardiorespiratory fitness. DISCUSSION: Low cardiorespiratory fitness can be improved through regular, aerobic exercise; however, this is challenging in non-ambulatory individuals. Regular, supported walking on a motorized treadmill can provide a stimulus for beneficial adaptations in the cardiorespiratory system even for functionally limited individuals. OUTCOME OF THE CASE: A 6-week customized incline treadmill program, two sessions per week for 1 hour per session were completed. Training protocols were adjusted every week through an increase of either incline, speed, and/or duration which were determined by the participant. Completion of modified graded treadmill test before and after treadmill training protocol showed improved cardiorespiratory fitness and improvement in ability to walk supported as indicated by lower HR, RR, RER in all previously completed stages, and the ability to complete 9 additional stages. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: The participant will continue to engage in a supported ambulatory treadmill training program twice a week for the next 6 months. Improvements in cardiorespiratory fitness will continue to be measured.
Recommended Citation
Rivero Romero, Krysta V.; Mikan, Vanessa PhD; and Merritt, Edward
(2025)
"Treadmill Training Program for a Non-Ambulatory Individual with Spastic Quadriplegic Cerebral Palsy,"
International Journal of Exercise Science: Conference Proceedings: Vol. 2:
Iss.
17, Article 197.
Available at:
https://digitalcommons.wku.edu/ijesab/vol2/iss17/197
Included in
Health and Physical Education Commons, Medical Education Commons, Sports Sciences Commons
