The Effectiveness of Task Oriented training (TOT) of on Gait function in children with spastic diaplegic cerebral palsy: A Randomised Control Trial.

Research Report
Population: Pediatric

Darshanaben Jashubhai Tadvi, PT, Clinical Therapist, PORTEA Home care Services, Vadodara, India

Vasanthan Rajagopalan, PT, Prof, The Oxford College of Physiotherapy,Bangalore, India

Subramanian Durairaj, PT, Asso. Prof., The oxford college Physiotherapy, Bangalore, India

Keywords: Participation, Task-Oriented Training, Gait

Background & Purpose: Prior studies have identified the effect of general task oriented training and shown positive effects on motor functions and balance performance in children with cerebral palsy. But we could not identify literature on use of variable contexts to modify and train tasks for gait function. Hence, the purpose of this study is to find the effectiveness of TOT on gait function in children with spastic diplegic cerebral palsy.

Subjects: 20 children between 5-10 years with spastic diplegic cerebral palsy were randomly allocated in 1:1 ratio to TOT and conventional therapy.

Methodology: The children in TOT group were provided tasks like sitting to standing, stair climbing, walking and intensity of task increased by increased variability and complexity. Children in conventional therapy group were provided traditional exercises like stretching, strengthening and mat exercises of sufficient intensity. Treatment was applied for 1 hour/day; 6 times/week for 2 weeks. Outcome of gross motor function was measured using GMFM – 66 (E item: walking, running, jumping) and walking performance using TUG test before and after 2 weeks.

Result: The children were of GMFCS level 1-3. The calculated Mean difference and 95% confidence interval of GMFM item E score of conventional and TOT group was (2.849 +/- 1.36) and (13.395 +/- 3.43) respectively and TUG score of control and experimental group was (22.9 +/- 12.57) and (36.6 +/- 21.29) respectively. The results however did not show statistically significant difference in TUG.

Conclusion: The context mediated task oriented training improved gait function on activity level effectively on GMFM. But there was no statistical significant improvement in walking performance on TUG. TOT Training focused on increasing variability and complexity. This might have engendered tangible task completion rather than increasing the speed of walking. This could be one reason for the observed differential effect.

Clinical Relevance: TOT is found effective for improving gait function. Implementing TOT intervention was feasible and could be an affordable alternate to mitigate cost and maximize benefit over more costly interventions.

Tadvi, Darshanaben Jashubhai, PT; Rajagopalan, Vasanthan , PT; Durairaj, Subramanian , PT. The Effectiveness of Task Oriented training (TOT) of on Gait function in children with spastic diaplegic cerebral palsy: A Randomised Control Trial.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online.